Is venous blood gas performed in the Emergency Department predictive of outcome during acute on chronic hypercarbic respiratory failure?

A 54-year-old woman prepares dinner around 8:00 pm that includes mushrooms that she picked from her yard. The next morning, around 8:00 am, the woman (patient), her daughter, and son-in-law all develop abdominal cramps, violent vomiting, and diarrhea. They present to the emergency department and are admitted for dehydration and intractable vomiting with a presumed diagnosis of food poisoning. Twenty-four hours later, they appear well with stable vital signs and improved symptoms. Four hours later, 36 hours post-ingestion, the patient becomes lethargic. A venous blood gas reveals pH, 7.1; PCO2, 16 mmHg; and her AST was 3140 units/L with an ALT of 4260 units/L and an INR of 3.7.

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Comparison of Arterial and Venous Blood Gas Values in the Initial Emergency Department Evaluation of Patients With Diabetic Ketoacidosis

Annals of Emergency Medicine ◽

10.1016/s0196-0644(98)70254-9 ◽

1998 ◽

Vol 31 (4) ◽

pp. 459-465 ◽

Cited By ~ 102

Author(s):

Mark A Brandenburg ◽

Daniel J Dire

Keyword(s):

Emergency Department ◽

Diabetic Ketoacidosis ◽

Venous Blood ◽

Blood Gas ◽

Department Evaluation ◽

Venous Blood Gas

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Accuracy of Peripheral and Central Venous Blood Gas Analysis in Evaluating Patients with Respiratory Failure

International Journal Of Applied Research and Studies ◽

10.20908/ijars.v6i07.8590 ◽

2017 ◽

Vol 6 (07) ◽

Author(s):

Marwa Salah Ghanem ◽

Heba Wagih Abdelwahab ◽

Nesrine Saad Farrag ◽

Ahmed M. Hamad

Keyword(s):

Respiratory Failure ◽

Venous Blood ◽

Blood Gas Analysis ◽

Gas Analysis ◽

Blood Gas ◽

Acid Base Balance ◽

Central Venous ◽

Arterial Blood ◽

Venous Blood Gas ◽

Venous Blood Gas Analysis

Objectives: Arterial blood samples are the gold standard test but these are more difficult to get than venous samples. In this study we assessed the possibility of utilization of venous (peripheral and central) blood gas samples in evaluation of subjects with respiratory failure instead of arterial samples. Methods: critically ill subjects with respiratory failure had paired venous (peripheral and central) and arterial samples taken. Assessment of agreement between blood gas samples (arterial and venous) as regard PH, Pco2 and HCO3 was done using Bland–Altman analyses. The spearmen correlation and linear regression tests were also performed to assess the degree of association between arterial and venous samples. Results: 100subjects were included. A good agreement was found between venous (peripheral and central) and arterial values of pHand HCO3.The agreements between peripheral venous and arterial PH and HCO3 values is higher than agreements between arterial and central venous measures. Conclusions: venous blood gas analysis (mainly peripheral samples) could replace arterial blood gas analysis in the evaluation of acid base balance in subjects with respiratory failure

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