Lactate, pH, and blood gas analysis in critically ill patients

Introduction: Arterial blood gas (ABG) analysis is the gold standard method and frequently performed intervention to evaluate acid-base status along with adequacy of ventilation and oxygenation among patients with predominantly critical / acute diseases. Aims And Objectives: The aim of this study is to evaluate the correlation of VBG analysis and pulse oximetry (SpO2) with ABG analysis in critically ill patients. Materials And Methods:Intensive Care Unit (ICU), Command Hospital (Eastern Command), Kolkata, Adult patients requiring arterial blood gas analysis, JAN 2018 –JUNE 2019, 100 critically ill patients and Age – 18yrs and older, Sex – Either sex. Conclusion: In this study population of critically ill patients, pH and pCO2 on VBG analysis correlated with pH and pCO2 on ABG analysis. The SpO2 correlated well with pO2 on ABG analysis

Download Full-text

Concordance between point-of-care blood gas analysis and laboratory autoanalyzer in measurement of hemoglobin and electrolytes in critically ill patients

Journal of Clinical Laboratory Analysis ◽

10.1002/jcla.22425 ◽

2018 ◽

Vol 32 (6) ◽

pp. e22425 ◽

Cited By ~ 6

Author(s):

Shivesh Prakash ◽

Shailesh Bihari ◽

Zhan Y. Lim ◽

Santosh Verghese ◽

Hemant Kulkarni ◽

...

Keyword(s):

Critically Ill ◽

Critically Ill Patients ◽

Point Of Care ◽

Blood Gas Analysis ◽

Gas Analysis ◽

Blood Gas

Download Full-text

Peripheral venous blood gas analysis: An alternative to arterial blood gas analysis for resuscitation and monitoring of critically ill patients.

Bangladesh Critical Care Journal ◽

10.3329/bccj.v4i2.30023 ◽

2016 ◽

Vol 4 (2) ◽

pp. 92-95

Author(s):

ASM Areef Ahsan ◽

Mohammad Omar Faruq ◽

Kaniz Fatema ◽

Fatema Ahmed ◽

Debasish Kumar Saha ◽

...

Keyword(s):

Critically Ill ◽

Critically Ill Patients ◽

Base Excess ◽

Blood Gases ◽

Blood Gas Analysis ◽

Gas Analysis ◽

Blood Gas ◽

Acid Base ◽

Venous Sample ◽

Acid Base Status

Objective: This study was aimed to compare between arterial and peripheral venous samples for blood gases and acid base status in critically ill patients and to evaluate if venous sample is a better alternative for initial assessment and resuscitation.Methods: This prospective study was conducted on 50 patients of more than 18 years of age in the department of Critical Care Medicine, BIRDEM General Hospital. Arterial and peripheral venous samples were taken within five minutes of each other and analyzed immediately for blood gases and acid base status. Mean difference and Pearson's product moment correlation coefficient was used to compare the result.Results: Mean difference and correlation coefficient between arterial and peripheral venous sample for pH, bicarbonate, base excess, PaCO2 and TCO2 value showed high correlation (r > 0.9). Comparison of electrolyte and hematocrit between arterial and peripheral venous sample also showed high correlation (r > 0.9).Conclusion: Peripheral venous gas analysis for pH, bicarbonate, base excess, PCO2 and Electrolytes (Na+, K+) show good correlation with the respective arterial values. This result suggests that venous estimations can be an acceptable alternative to arterial measurements for managing critically ill patients.Bangladesh Crit Care J September 2016; 4 (2): 92-95

Download Full-text

Short-Term Outcome and Characteristics of Critical Care for Non-Trauma Patients in the Emergency Department

10.21203/rs.3.rs-36412/v1 ◽

2020 ◽

Author(s):

Jessika Stefanie Kreß ◽

Marc Rüppel ◽

Hendrik Haake ◽

Jürgen vom Dahl ◽

Sebastian Bergrath

Keyword(s):

Critical Care ◽

Critically Ill ◽

Critically Ill Patients ◽

Blood Gas Analysis ◽

Patient Characteristics ◽

Gas Analysis ◽

Trauma Patients ◽

Blood Gas ◽

Short Term ◽

Resuscitation Room

Abstract Background: Emergency medical care for critically ill patients varies between different emergency departments (ED) and health care systems, while resuscitation of trauma patients is always performed within the ED. In many ED critically ill patients are treated and stabilized while in many German ED they are transferred to intensive care units (ICU) without performing of critical care measures in the ED. Against this background we conducted this retrospective analysis of prospectively collected critically ill patients treated with an ED critical care concept in a 754-bed teaching hospital. Methods: The collective of prospectively collected critically ill patients (October 1st 2018 to March 31st 2019) was analysed after ethical approval. Patient characteristics, performed critical care measures, short-term outcomes and the comparison of admission characteristics between survivors and non-survivors were evaluated. Additionally the accordance of ED diagnoses and discharge diagnoses were analysed.Results: Overall 243/19,854 patients (1.22%) were treated within the resuscitation room. After exclusion of trauma patients, 193 critically ill patients were included. Overall mortality was 29% (n=56), 24-hour mortality was 13% (n=25). Patient characteristics (vital signs, blood gas analysis) differed significantly between survivors and non-survivors except for respiratory rate and pain scale. Conducted critical care measures (number ± standard deviation; e.g. endotracheal intubation, arterial-line): 4.06±1.73 (survivors) and 4.70±2.0 (non-survivors) p=0.0453. The length of ED stay was 148.2±202.7 min. Admission diagnoses matched with hospital discharge diagnoses in 73.7%.Conclusions: Critical care stabilisation of non-trauma patients was feasible in routine care. The observed mortality was high and non-survivors showed significantly more impaired vital parameters and blood gas analysis parameters. Vital parameters together with blood gas analysis enable ED risk stratification of CIP. Although a first diagnostic workup was performed within the ED, admission and discharge diagnoses matched only in 73.7%. However, stabilisation and diagnostic workup of CIP enables optimal allocation to specialized ICUs. Future (randomised) trials have to evaluate of resuscitation room stabilisation for non-trauma patients is beneficial in contrast to direct ICU admission. Trial registration: The study was registered retrospectively in the Clinical Trials Centre of the RWTH Aachen University (Germany), registration number CTC-A 20-131.

Download Full-text

A Comparative Study of Arterial and Venous Blood Gas Analysis in Critically Ill Patients

International Journal of Contemporary Medicine ◽

10.5958/2321-1032.2019.00011.1 ◽

2019 ◽

Vol 7 (1) ◽

pp. 53

Author(s):

Aravind Prasad ◽

Shweta Sahai ◽

M A Linu ◽

V Arun ◽

Aman Yadav

Keyword(s):

Comparative Study ◽

Critically Ill ◽

Critically Ill Patients ◽

Venous Blood ◽

Blood Gas Analysis ◽

Gas Analysis ◽

Blood Gas ◽

Venous Blood Gas ◽

Venous Blood Gas Analysis

Download Full-text

Accuracy and Stability of a Subcutaneous Flash Glucose Monitoring System in Critically Ill Patients

Journal of Diabetes Science and Technology ◽

10.1177/19322968211017203 ◽

2021 ◽

pp. 193229682110172

Author(s):

Hiromu Naraba ◽

Tadahiro Goto ◽

Mitsuhiro Tokuda ◽

Tomohiro Sonoo ◽

Hidehiko Nakano ◽

...

Keyword(s):

Critically Ill ◽

Critically Ill Patients ◽

Glucose Monitoring ◽

Blood Gas Analysis ◽

Relative Difference ◽

Gas Analysis ◽

Blood Gas ◽

Flash Glucose Monitoring ◽

Grid Analysis ◽

Error Grid

Background: Flash glucose monitoring (FGM) systems can reduce glycemic variability and facilitate blood glucose management within the target range. However, in critically ill patients, only small ( n < 30) studies have examined the accuracy of FGM and none have assessed the stability of FGM accuracy. We evaluated the accuracy and stability of FGM in critically ill patients. Method: This was a single-center, retrospective observational study. We included a total of 116 critically ill patients who underwent FGM for glycemic control. The accuracy of FGM was assessed as follows using blood gas glucose values as a reference: (1) numerical accuracy using the mean absolute relative difference, (2) clinical accuracy using consensus error grid analysis, and (3) stability of accuracy assessing 14-day trends in consensus error grid distribution. Results: FGM sensors remained in situ for a median of 6 [4, 11] days. We compared 2014 pairs of measurements between the sensor and blood gas analysis. Glucose values from the sensor were consistently lower, with a mean absolute relative difference of 13.8% (±16.0%), than those from blood gas analysis. Consensus error grid analysis demonstrated 99.4% of the readings to be in a clinically acceptable accuracy zone. The accuracy of FGM was stable across the 14 days after device insertion. Conclusions: FGM had acceptable reliability and accuracy to arterial blood gas analysis in critically ill patients. In addition, the accuracy of FGM persisted for at least 14 days. Our study promotes the potential usefulness of FGM for glycemic monitoring in critically ill patients.

Download Full-text

Iatrogenic Anaemia in the Critically Ill: A Survey of the Frequency of Blood Testing in a Teaching Hospital Intensive Care Unit

Journal of the Intensive Care Society ◽

10.1177/175114370901000413 ◽

2009 ◽

Vol 10 (4) ◽

pp. 279-281 ◽

Cited By ~ 1

Author(s):

Tim Astles

Keyword(s):

Intensive Care ◽

Critically Ill ◽

Teaching Hospital ◽

Blood Gas Analysis ◽

Gas Analysis ◽

Blood Gas ◽

Arterial Blood Gas ◽

Day Range ◽

Arterial Blood ◽

Blood Gas Analyses

Anaemia in the critically ill remains a contentious issue. Despite adoption of lower haemoglobin levels as transfusion triggers, many patients on intensive care units (ICUs) still require blood transfusions during their illness. One factor that contributes to the critically ill becoming anaemic is regular phlebotomy. Over a two week period, all blood tests performed on patients in a busy, teaching hospital ICU were surveyed to allow calculation of the total volume of blood that had been taken. On average, 52.4 mL of blood was taken per patient per day, and 366.8 mL per patient per week. The most frequently performed tests were arterial blood gas analyses, performed on average 5.8 times per patient per day (range 0–21 times per day). Arterial blood gas analysis alone accounted for taking of 29 mL of blood per patient per day, ie 203 mL per patient per week. Several methods for reducing the amount of blood taken from ICU patients have been identified and discussed. By implementing some of these simple changes in our institution, it would be possible to reduce the volume of blood taken by 43%.

Download Full-text

Elevated admission lactate levels in the emergency department are associated with increased 30-day mortality in non-trauma critically ill patients

Scandinavian Journal of Trauma Resuscitation and Emergency Medicine ◽

10.1186/s13049-020-00777-y ◽

2020 ◽

Vol 28 (1) ◽

Cited By ~ 2

Author(s):

Michael Bernhard ◽

Stephanie Döll ◽

Andre Kramer ◽

Lorenz Weidhase ◽

Thomas Hartwig ◽

...

Keyword(s):

Emergency Department ◽

Critically Ill ◽

Critically Ill Patients ◽

Blood Gas Analysis ◽

Gas Analysis ◽

Study Endpoint ◽

Resuscitation Room ◽

Patients At Risk ◽

Risk Patients ◽

Lactate Levels

Abstract Background Elevated blood lactate levels were reported as useful predictors of clinical outcome and mortality in critically ill patients. To identify higher-risk patients, this investigation evaluated the relationship between patient mortality and admission lactate levels during the management of non-trauma critically ill patients in the emergency department (ED). Methods In this prospective, single centre observational study in a German university ED, all adult patients who were admitted to the ED resuscitation room were evaluated between September 1, 2014 and August 31, 2015. Blood samples for blood gas analysis, including lactate levels, were obtained immediately at admission. Study endpoint was 30-day mortality. Results During the study period, 532 patients were admitted to the resuscitation room of the ED. The data of 523 patients (98.3%) were available. The overall 30-day mortality was 34.2%. Patients presenting to the resuscitation room with admission lactate levels < 2.0 mmol/l had a 30-day mortality of 22.7%, while admission lactate levels above 8.0 mmol/l were associated with higher mortality (8.0–9.9 mmol/l: OR: 2.83, 95%CI: 1.13–7.11, p = 0.03, and ≥ 10 mmol/l: OR: 7.56, 95%CI: 4.18–13.77, p < 0.001). Conclusion High lactate levels at admission are associated with an increased 24-h and 30-day mortality. These measurements may be used not only to predict mortality, but to help identify patients at risk for becoming critically ill. The breakpoint for mortality may be an ALL ≥8.0 mmol/l.

Download Full-text