scholarly journals P1‐14: Venous blood gases versus arterial blood gases in the titration of acute non‐invasive ventilation

Respirology ◽  
2021 ◽  
Vol 26 (S3) ◽  
pp. 75-75
2015 ◽  
Vol 35 (5) ◽  
pp. 873-881 ◽  
Author(s):  
Christopher K Willie ◽  
David B MacLeod ◽  
Kurt J Smith ◽  
Nia C Lewis ◽  
Glen E Foster ◽  
...  

The effects of partial acclimatization to high altitude (HA; 5,050 m) on cerebral metabolism and cerebrovascular function have not been characterized. We hypothesized (1) increased cerebrovascular reactivity (CVR) at HA; and (2) that CO2 would affect cerebral metabolism more than hypoxia. PaO2 and PaCO2 were manipulated at sea level (SL) to simulate HA exposure, and at HA, SL blood gases were simulated; CVR was assessed at both altitudes. Arterial–jugular venous differences were measured to calculate cerebral metabolic rates and cerebral blood flow (CBF). We observed that (1) partial acclimatization yields a steeper CO2-H+ relation in both arterial and jugular venous blood; yet (2) CVR did not change, despite (3) mean arterial pressure (MAP)-CO2 reactivity being doubled at HA, thus indicating effective cerebral autoregulation. (4) At SL hypoxia increased CBF, and restoration of oxygen at HA reduced CBF, but neither had any effect on cerebral metabolism. Acclimatization resets the cerebrovasculature to chronic hypocapnia.


1965 ◽  
Vol 208 (4) ◽  
pp. 798-800 ◽  
Author(s):  
Hugo Chiodi ◽  
James W. Terman

Individual blood samples were collected anaerobically from the brachial arteries of adult White Rock hens and were analyzed for Po2, Pco2, pH, oxygen content and capacity, and CO2 content and capacity. A dissociation curve was constructed from data on equilibration of pooled venous blood. The average arterial oxygen saturation was 90%, the Pco2 was about 32 mm Hg, the Po2 was between 94 and 99 mm Hg, and the pH averaged 7.49. The dissociation curve, as has been shown before, was shifted to the right of most homeothermic species.


2012 ◽  
Vol 9 (4) ◽  
pp. 256-259 ◽  
Author(s):  
R Pandey ◽  
R Chokhani ◽  
N B K C

Background Non-invasive ventilation (NIV) has become an integral tool in the management of acute and chronic respiratory failure. Studies have shown that use of NIV decreases the length of hospital stay, improves symptoms and also reduces the need for invasive mechanical ventilation in patients with respiratory failure. However, NIV is not used sufficiently in our country. Objective To find out the outcome of Non Invasive Ventilation in Respiratory failure in Nepal. Methods Retrospective analysis of data of 28 patients in between June 2010- November 2010 was done. All the patients selected had respiratory failure. Records were analysed for documentation of clinical diagnosis. Arterial blood gases were assessed prior to, after starting and after discontinuation of NIV. The outcome of NIV and the need for domiciliary oxygen was evaluated at discharge. Results Thirty four patients received NIV out of which 6 were excluded from the study due to insufficient documentation. Out of these 28 patients, 27 received bi-level and one patient received Continuous Positive Airway Pressure. Mean age of patients was 66.5 years and ranged from 42-87 years. Majority (19, 79%) were from age group 60-80 years. Most common cause for the use of bi-level ventilation was chronic obstructive pulmonary disease with type 2 respiratory failure in 19 patients (67.8%). Others included obesity hypoventilation syndrome two, acute interstitial pneumonia two, cardiogenic pulmonary oedema two, Interstitial lung disease one, bronchogenic carcinoma one, and bronchiectasis one. Arterial blood gas analysis was done on admission and 12 hours or earlier after the onset of bi-level ventilation. At the time of admission, 89.3% of the patients had type 2 respiratory failure, of which 60.6% had respiratory acidosis and 67.9% of patients had pCO2 above 60 mm Hg. Arterial blood pH prior to admission ranged from 7.19 to 7.50. Twelve hours after bi-level ventilation, only 21.3% had pH <7.35 and 42.8% had pCO2 above 60 mm Hg. Non invasive ventilation was successful in 27 patients (96.4%). All patients were advised domiciliary oxygen and all patients had respiratory follow up arranged. Conclusions COPD patients with type 2 respiratory failure were seen to benefit most with NIV. It is a very cost effective and safe method of treatment and should be used first in patients with COPD with type 2 respiratory failure.DOI: http://dx.doi.org/10.3126/kumj.v9i4.6340 Kathmandu Univ Med J 2011;9(4):256-59


2019 ◽  
Vol 6 (4) ◽  
pp. 1016
Author(s):  
Sabiha Naz ◽  
Kiran Chugh ◽  
Isha Malik

Background: It is clearly mentioned in the medicine books that blood gas analysis from arterial puncture is the gold standard. But in the past few years it is commonly seen that clinicians have started trusting on venous blood gas analysis as well as started advising VBG (Venous blood gas) in the initial diagnosis of critical patients in emergency setting. Keeping this fact in mind, we designed a study to determine whether VBG could be a better replacement of ABG (Arterial blood gases) in the emergency where diverse pathological conditions are encountered.Methods: This prospective cross-sectional study comprised of 50 patients of 20-60 yrs age with a variety of diagnoses admitted in the emergency department. 50 paired samples (ABG+VBG) were obtained from them under strict aseptic precautions after obtaining their verbal consent. With a minimum delay of less than 2 min blood gas analysis was performed on blood gas analyzer. Parameters (pH, PCO2, PO2, HCO3, Base Excess and O2 saturation) from ABG and VBG were recorded and compared using Student’s Unpaired ‘t’ test.Results: pH and HCO3 showed statistical significant (p value <0.05) differences between ABG and VBG, while BE showed statistical non-significant (p value >0.05) difference between them. Contrary to this, PCO2, PO2 and O2 saturation from ABG and VBG showed statistical highly significant (p value <0.0001) differences.Conclusions: VBG should not be interchangeably considered in place of ABG with regard to pH, HCO3, PCO2, PO2 and O2 saturation in conditions where actual oxygenation status of patient is required (e.g.; hypovolemic shock, respiratory disorders, mechanically ventilated patients, etc.)


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