A combination of clinical parameters and blood–gas analysis identifies patients at risk of transfer to intensive care upon arrival to the Emergency Department

2016 ◽  
Vol 23 (4) ◽  
pp. 305-310
Author(s):  
Maria Bjørn ◽  
Jakúp W. Simonsen ◽  
Christian B. Mogensen
Keyword(s):  
At Risk ◽  
Emergency Department ◽  
Intensive Care ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Clinical Parameters ◽  
Blood Gas ◽  
Patients At Risk

scholarly journals Be cautious during the interpretation of arterial blood gas analysis performed outside the intensive care unit

2020 ◽  
Author(s):  
Lukasz Krzych ◽  
Olga Wojnarowicz ◽  
Paweł Ignacy ◽  
Julia Dorniak
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Point Of Care ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Blood Gas ◽  
Acid Base Balance ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
The Impact

Introduction. Reliable results of an arterial blood gas (ABG) analysis are crucial for the implementation of appropriate diagnostics and therapy. We aimed to investigate the differences (Δ) between ABG parameters obtained from point-of-care testing (POCT) and central laboratory (CL) measurements, taking into account the turnaround time (TAT). Materials and methods. A number of 208 paired samples were collected from 54 intensive care unit (ICU) patients. Analyses were performed using Siemens RAPIDPoint 500 Blood Gas System on the samples just after blood retrieval at the ICU and after delivery to the CL. Results. The median TAT was 56 minutes (IQR 39-74). Differences were found for all ABG parameters. Median Δs for acid-base balance ere: ΔpH=0.006 (IQR –0.0070–0.0195), ΔBEef=–0.9 (IQR –2.0–0.4) and HCO3–act=–1.05 (IQR –2.25–0.35). For ventilatory parameters they were: ΔpO2=–8.3 mmHg (IQR –20.9–0.8) and ΔpCO2=–2.2 mmHg (IQR –4.2––0.4). For electrolytes balance the differences were: ΔNa+=1.55 mM/L (IQR 0.10–2.85), ΔK+=–0.120 mM/L (IQR –0.295–0.135) and ΔCl–=1.0 mM/L (IQR –1.0–3.0). Although the Δs might have caused misdiagnosis in 51 samples, Bland-Altman analysis revealed that only for pO2 the difference was of clinical significance (mean: –10.1 mmHg, ±1.96SD –58.5; +38.3). There was an important correlation between TAT and ΔpH (R=0.45, p<0.01) with the safest time delay for proper assessment being less than 39 minutes. Conclusions. Differences between POCT and CL results in ABG analysis may be clinically important and cause misdiagnosis, especially for pO2. POCT should be advised for ABG analysis due to the impact of TAT, which seems to be the most important for the analysis of pH.

scholarly journals A Comparison of Arterial and Venous Blood Gas Analysis and Its Interpretation in Emergency Department: A Cross-Sectional Study

2021 ◽  
Vol 20 (3) ◽  
pp. 178-182
Author(s):  
Ram Kirubakar Thangaraj ◽  
Hari Hara Sudhan Chidambaram ◽  
Melvin Dominic ◽  
V.P. Chandrasekaran ◽  
Karthik Narayan Padmanabhan ◽  
...  
Keyword(s):  
Emergency Department ◽  
Venous Blood ◽  
Blood Gas Analysis ◽  
Cross Sectional Study ◽  
Gas Analysis ◽  
Blood Gas ◽  
Sectional Study ◽  
Cross Sectional ◽  
Venous Blood Gas ◽  
Venous Blood Gas Analysis

Transcutaneous Po2 Monitoring in Routine Management of Infants and Children With Cardiorespiratory Problems

PEDIATRICS ◽  
1976 ◽  
Vol 57 (5) ◽  
pp. 681-690
Author(s):  
R. Huch ◽  
A. Huch ◽  
M. Albani ◽  
M. Gabriel ◽  
F. J. Schulte ◽  
...  
Keyword(s):  
Intensive Care ◽  
Pediatric Intensive Care ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Blood Gas ◽  
Close Correspondence ◽  
Arterial Po2 ◽  
Transcutaneous Po2 ◽  
Made In

Results are reported concerning the clinical application of the transcutaneous Po2 method (tc Po2 method) according to Huch et al. for monitoring arterial Po2. Thirty long-term continuous tc Po2 recordings were made in 22 ventilated children and infants with cardiorespiratory problems in four different pediatric intensive care units (Zürich, Göttingen, Kassel, and Mainz). These recordings were compared with 132 arterial Po2 determinations made during the same period of time. There was a linear relationship and a close correspondence between arterial Po2 and tc Po2 (r = .94). The continuous recordings have shown that the variability of Po2 is much greater than assumed so far by single blood gas analysis. This fact restricts greatly the value of single samples. Continuous tc Po2 monitoring has proved to be a great help in optimal respirator setting.

scholarly journals Comparing the Liquid Heparin Syringe with Dry Bound Heparin Syringe for Blood Gas Analysis

2019 ◽  
Vol 3 (02) ◽  
pp. 059-067
Author(s):  
Manoj Kumar Sahu ◽  
Seshagiribabu Yagani ◽  
Dharmraj Singh ◽  
Umed Singh ◽  
Sarvesh Pal Singh ◽  
...  
Keyword(s):  
Intensive Care ◽  
Partial Pressure ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Surgical Patients ◽  
Arterial Oxygen ◽  
Surgical Intensive Care Unit ◽  
Blood Gas ◽  
Surgical Intensive Care ◽  
Accurate Analysis

Abstract Background Blood gas (BG) analysis is routine today for patient management in intensive care units. Accurate analysis of different parameters in the BG is essential for managing critical patients. Errors in BG analysis can happen at many levels, with one of them being at sampling and heparinization. We compared self-prepared heparinized syringes rinsed with liquid heparin (LH) and the standard commercially available syringes with dry bound heparin (DBH) for arterial BG analysis of postoperative cardiac surgical patients. Methods This prospective observational study was conducted in 100 consecutive adult cardiac surgical patients in the cardiac surgical intensive care unit. Paired samples were collected, analyzed immediately, and statistically compared for pH, partial pressure of arterial oxygen (pO2), partial pressure of arterial carbon dioxide (pCO2), oxyhemoglobin saturation (SaO2), HCO, Na+, K+, Cl–, Ca2+, Mg2+, base excess (BE), hemoglobin (Hb), hematocrit, glucose, and lactate. Paired parameters were compared and agreement was evaluated using Bland–Altman difference plots. The 95% limits of absolute agreement (LOA) were compared with total allowable error (TEa). Results The BG parameters analyzed by two types of heparinized (LH and DBH) syringes were found to be comparable with a negligible mean difference and had an agreement outside the TEa of 8% for pO2, pCO2, and hematocrit, 7% for BE, 6% for Mg2+, 5% for K+, Ca2+, and lactate, 4% for HCOand Na+, 3% for pH, Cl–, Hb, and glucose, and zero for SaO2. The two types of syringes did not show clinically relevant discrepancies among many different parameters as per LOA and TEa limits. Conclusion In this study, we found that the BG parameters—respiratory, metabolic, and electrolytes—were comparable between the two types of syringes used for sampling. Unlike some previous studies, we did not find statistically significant differences among these analytes, which might have been due to appropriate self-preparation of heparin syringes.

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