Assessing Acid-Base Status in Circulatory Failure. Differences Between Arterial and Central Venous Blood

1989 ◽  
Vol 33 (6) ◽  
pp. 339 ◽  
Author(s):  
H. J. ADROGUE ◽  
N. RASHAD ◽  
A. B. GORIN ◽  
J. YACOUB ◽  
N. E. MADIAS
Keyword(s):  
Venous Blood ◽  
Circulatory Failure ◽  
Central Venous ◽  
Acid Base ◽  
Central Venous Blood ◽  
Acid Base Status

scholarly journals Central venous blood gas and acid-base status in conscious dogs and cats

2015 ◽  
Vol 77 (7) ◽  
pp. 865-869 ◽  
Author(s):  
Jun TAMURA ◽  
Takaharu ITAMI ◽  
Tomohito ISHIZUKA ◽  
Sho FUKUI ◽  
Kenjirou MIYOSHI ◽  
...  
Keyword(s):  
Venous Blood ◽  
Conscious Dogs ◽  
Blood Gas ◽  
Central Venous ◽  
Acid Base ◽  
Central Venous Blood ◽  
Acid Base Status ◽  
Venous Blood Gas

Assessing Acid–Base Status in Circulatory Failure: Relationship Between Arterial and Peripheral Venous Blood Gas Measurements in Hypovolemic Shock

2018 ◽  
Vol 35 (5) ◽  
pp. 511-518
Author(s):  
Scott E. Rudkin ◽  
Craig L. Anderson ◽  
Tristan R. Grogan ◽  
David A. Elashoff ◽  
Richard M. Treger
Keyword(s):  
Venous Blood ◽  
Hypovolemic Shock ◽  
Circulatory Failure ◽  
Blood Gas ◽  
Central Venous ◽  
Acid Base ◽  
Arterial Blood ◽  
Acid Base Status ◽  
Venous Blood Gas ◽  
The Relationship

Background and Objectives: In severe circulatory failure agreement between arterial and mixed venous or central venous values is poor; venous values are more reflective of tissue acid–base imbalance. No prior study has examined the relationship between peripheral venous blood gas (VBG) values and arterial blood gas (ABG) values in hemodynamic compromise. The objective of this study was to examine the correlation between hemodynamic parameters, specifically systolic blood pressure (SBP) and the arterial–peripheral venous (A-PV) difference for all commonly used acid–base parameters (pH, Pco 2, and bicarbonate). Design, Setting, Participants, and Measurements: Data were obtained prospectively from adult patients with trauma. When an ABG was obtained for clinical purposes, a VBG was drawn as soon as possible. Patients were excluded if the ABG and VBG were drawn >10 minutes apart. Results: The correlations between A-PV pH, A-PV Pco 2, and A-PV bicarbonate and SBP were not statistically significant ( P = .55, .17, and .09, respectively). Although patients with hypotension had a lower mean arterial and peripheral venous pH and bicarbonate compared to hemodynamically stable patients, mean A-PV differences for pH and Pco 2 were not statistically different ( P = .24 and .16, respectively) between hypotensive and normotensive groups. Conclusions: In hypovolemic shock, the peripheral VBG does not demonstrate a higher CO2 concentration and lower pH compared to arterial blood. Therefore, the peripheral VBG is not a surrogate for the tissue acid–base status in hypovolemic shock, likely due to peripheral vasoconstriction and central shunting of blood to essential organs. This contrasts with the selective venous respiratory acidosis previously demonstrated in central venous and mixed venous measurements in circulatory failure, which is more reflective of acid–base imbalance at the tissue level than arterial blood. Further work needs to be done to better define the relationship between ABG and both central and peripheral VBG values in various types of shock.

The Accuracy of the Central Venous Blood Gas for Acid-Base Monitoring

2009 ◽  
Vol 25 (2) ◽  
pp. 104-110 ◽  
Author(s):  
Allan J. Walkey ◽  
Harrison W. Farber ◽  
Charles O'Donnell ◽  
Howard Cabral ◽  
Janet S. Eagan ◽  
...  
Keyword(s):  
Venous Blood ◽  
Blood Gas ◽  
Central Venous ◽  
Acid Base ◽  
Central Venous Blood ◽  
Venous Blood Gas

scholarly journals Accuracy of Acid-Base Diagnoses Using the Central Venous Blood Gas in the Medical Intensive Care Unit

Nephron ◽  
2018 ◽  
Vol 139 (4) ◽  
pp. 293-298 ◽  
Author(s):  
Sarah J. Schrauben ◽  
Dan Negoianu ◽  
Cristiana Costa ◽  
Raphael M. Cohen ◽  
Stanley Goldfarb ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Medical Intensive Care Unit ◽  
Venous Blood ◽  
Blood Gas ◽  
Central Venous ◽  
Acid Base ◽  
Central Venous Blood ◽  
Medical Intensive Care ◽  
Venous Blood Gas

CENTRAL VENOUS BLOOD AS AN INDEX OF ACID-BASE OXYGENATION STATUS

1969 ◽  
Vol 13 (3) ◽  
pp. 227
Author(s):  
P. R. RAMACHANDRAN ◽  
H. B. FAIRLEY ◽  
A. K. LAWS
Keyword(s):  
Venous Blood ◽  
Central Venous ◽  
Acid Base ◽  
Central Venous Blood ◽  
Oxygenation Status

Intraosseous and central venous blood acid-base relationship during cardiopulmonary resuscitation

1997 ◽  
Vol 13 (4) ◽  
pp. 250-253 ◽  
Author(s):  
NIRANJAN KISSOON ◽  
AHMED IDRIS ◽  
VOLKER WENZEL ◽  
SUZANNE MURPHY ◽  
WILLIAM RUSH
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Venous Blood ◽  
Central Venous ◽  
Acid Base ◽  
Central Venous Blood

Study of Acid-Base in Arterial and Central Venous Blood during

2001 ◽  
Vol 41 (6) ◽  
pp. 685
Author(s):  
Min Sun Jeon ◽  
Hee Koo Yoo ◽  
Jae Chul Shim ◽  
Mi Ae Cheong ◽  
Jeong Woo Jeon ◽  
...  
Keyword(s):  
Venous Blood ◽  
Central Venous ◽  
Acid Base ◽  
Central Venous Blood

scholarly journals Arterial, Mixed Venous or Central Venous Hemogasometry and End Tidal CO2 in Dogs under Different Hemodynamic States

2017 ◽  
Vol 45 (1) ◽  
pp. 8
Author(s):  
Martielo Ivan Gehrcke ◽  
Doughlas Regalin ◽  
Vanessa Sasso Padilha ◽  
Felipe Comassetto ◽  
Gizelli Da Silva ◽  
...  
Keyword(s):  
Tissue Oxygenation ◽  
Pulmonary Ventilation ◽  
Venous Blood ◽  
Acid Base Balance ◽  
Central Venous ◽  
Acid Base ◽  
Central Venous Blood ◽  
Arterial Blood ◽  
Base Balance ◽  
Mixed Venous

Background: Hemogasometric analysis is used in the interpretation of acid-base balance (ABB) and to access pulmonary ventilation. Already mixed venous oxygen saturation obtained at pulmonary artery correlates with tissue oxygenation. However, both samples can be difficult to access because of the difficulties in arterial and pulmonary catheterization. The aim of this study was to evaluate the feasibility of replacing the arterial and mixed venous bloods, the end tidal pressure of carbon dioxide (EtCO2) and central venous blood in the analysis of pulmonary ventilation, tissue oxygenation and ABB in dogs under different hemodynamic states.Material, Methods & Results: Nine dogs were used with an average weight of 19.6 ± 1.3 kg, anesthetized with isoflurane at 1.4 V% diluted on oxygen 60% (Baseline), and subsequently undergoing mechanical ventilation (MV) and the hypodinamic state (Hypo) with isoflurane at 3.5V% and mean arterial pressure (MAP) lower than 50 mmHg and hyperdynamic state (Hyper) by dobutamine infusion at 5 μg/kg/min and with MAP 30% higher than baseline. For each time allowed a 15 min of stabilization by each hemodynamic status. Simultaneously were collected samples of 0.6 mL of arterial blood by metatarsal artery, mixed and central venous blood by pulmonary artery and right atrium for hemogasometric analysis. To access lung function we correlated and compared the EtCO2 values obtained by gas analyzer with expired carbon dioxide pressure in the arterial blood (PaCO2), mixed venous blood (PmvCO2) and central venous blood (PcvCO2). For the interpretation of tissue oxygenation we correlated and compared the values of mixed (SmvO2) and central (ScvO2) venous oxygen saturation. For the acid-base balance we used the correlation of potencial hydrogen (pH); carbon dioxide pressure (PCO2); bicarbonate ion (HCO3-); base excess (BE); anion GAP (AG); sodium ions (Na+), chlorine ions (Cl-), potassium ions (K+) and ionized calcium (iCa) of arterial (a) mixed venous (mv) and central venous (CV) bloods. Statistical analysis was performed using ANOVA-RM followed by Dunnet test for differences between times and Tukey’s test for differences among the samples (P ≤ 0.05). Pearson correlation analysis was performed using linear regression and for comparison methods we used the Bland-Altman analysis The EtCO2 values correlated (r = 0.87) and were according to Bland-Altman analysis with PaCO2 values (mean difference of -1.6 ± 2,9 mmHg for PaCO2. There were no differences (P ≤ 0.05) from SmvO2 and ScvO2. ScvO2 correlated (r = 0.91) with SmvO2 at different hemodynamic states and with a mean difference of -0.4 ± 2.5%. Both venous bloods were correlated with the analysis of arterial blood acid-base balance and electrolytes in different hemodynamic states. However, the ionized calcium levels were 40% lower in arterial blood.Discussion: EtCO2 measurement depends of monitor technology and proper pulmonar ventilation and perfusion. In this study the limiting factor in replacing the PaCO2 hair EtCO2 was spontaneous ventilation because in this state pulmonary ventilation is compromissed. With the use of MV was possible get up similar results in the pulmonar function analysis using the EtCO2 and PaCO2. The use of central venous blood instead mixed venous blood at oxygen saturation analysis provided adequate estimate this parameter. This being easier and less invasive technique. ABB was possible with all samples with own reference values for venous and arterial samples. This is an interesting result for critical patients where the arterial sample is difficult. In electrolytes the sample was indifferent except for calcium because pH interfere in this values. It was conclude that the values of EtCO2 and central venous blood are correlated and can replace arterial and mixed venous bloods in the analysis of lung function, tissue oxygenation and acid base balance.

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