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

2009 ◽  
Vol 10 (4) ◽  
pp. 279-281 ◽  
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%.

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.

CORRELATION OF VENOUS BLOOD GAS AND PULSE OXIMETRY WITH ARTERIAL BLOOD GAS IN CRITICALLY ILL PATIENTS

2021 ◽  
pp. 1-3
Author(s):  
Sritam Mohanty ◽  
Rangaraj Setlur ◽  
Jyoti Kumar Sinha
Keyword(s):  
Pulse Oximetry ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Venous Blood ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Blood Gas ◽  
Gold Standard Method ◽  
Arterial Blood Gas ◽  
Arterial Blood

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

Effects of Administration of Intravenous Naloxone on Gas Exchange in Brain-Dead Lung Donors

2009 ◽  
Vol 19 (3) ◽  
pp. 267-271 ◽  
Author(s):  
Christina Eagan ◽  
Cesar A. Keller ◽  
Maher A. Baz ◽  
Michael Thibault
Keyword(s):  
Lung Transplant ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Pulmonary Contusion ◽  
Neurogenic Pulmonary Edema ◽  
Blood Gas ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Arterial Blood Gas Analysis ◽  
Blood Gas Analyses

Objective To observe the effect of naloxone on the lung function of potential lung transplant donors with neurogenic pulmonary edema. Design and Interventions Donors aged 16 to 55 years without any factors to contraindicate lung donation (pneumonia, pulmonary contusion, etc) were included. Ventilator settings were standardized to a tidal volume of 10 to 12 mL/kg, an FiO2 of 0.40, and a respiratory rate that kept PCO2 between 35 and 45 mm Hg. Chest physiotherapy, nebulizer treatments, and frequent suctioning were undertaken. Baseline arterial blood gas analysis and an oxygen challenge were performed. The patients were then given 8 to 10 mg of naloxone. Oxygen challenges and arterial blood gas analyses were repeated every 4 to 6 hours. The data were analyzed by using a paired t test, and each patient served as his or her own control. Setting These interventions were performed on the 19 LifeQuest donors who met the set criteria from July 2002 to July 2004. Results The PaO2 on the oxygen challenge immediately after administration of naloxone increased from 329 (SD 177) to 363 (SD 191) mm Hg, although the increase from baseline was not significant. The PaO2 from the second oxygen challenge (median time, 7 hours after administration of naloxone) increased to 413 (SD 177) mm Hg ( P < .01).

scholarly journals Working accuracy of pulse oximetry in COVID-19 patients stepping down from intensive care: a clinical evaluation

2020 ◽  
Vol 7 (1) ◽  
pp. e000778
Author(s):  
Keir Elmslie James Philip ◽  
Benjamin Bennett ◽  
Silas Fuller ◽  
Bradley Lonergan ◽  
Charles McFadyen ◽  
...  
Keyword(s):  
Intensive Care ◽  
Pulse Oximetry ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Blood Gas ◽  
Limits Of Agreement ◽  
Arterial Blood Gas ◽  
Paired Samples ◽  
Arterial Blood ◽  
Step Down

IntroductionUK guidelines suggest that pulse oximetry, rather than blood gas sampling, is adequate for monitoring of patients with COVID-19 if CO2 retention is not suspected. However, pulse oximetry has impaired accuracy in certain patient groups, and data are lacking on its accuracy in patients with COVID-19 stepping down from intensive care unit (ICU) to non-ICU settings or being transferred to another ICU.MethodsWe assessed the bias, precision and limits of agreement using 90 paired SpO2 and SaO2 from 30 patients (3 paired samples per patient). To assess the agreement between pulse oximetry (SpO2) and arterial blood gas analysis (SaO2) in patients with COVID-19, deemed clinically stable to step down from an ICU to a non-ICU ward, or be transferred to another ICU. This was done to evaluate whether the guidelines were appropriate for our setting.ResultsMean difference between SaO2 and SpO2 (bias) was 0.4%, with an SD of 2.4 (precision). The limits of agreement between SpO2 and SaO2 were as follows: upper limit of 5.2% (95% CI 6.5% to 4.2%) and lower limit of −4.3% (95% CI −3.4% to −5.7%).ConclusionsIn our setting, pulse oximetry showed a level of agreement with SaO2 measurement that was slightly suboptimal, although within acceptable levels for Food and Drug Authority approval, in people with COVID-19 judged clinically ready to step down from ICU to a non-ICU ward, or who were being transferred to another hospital’s ICU. In such patients, SpO2 should be interpreted with caution. Arterial blood gas assessment of SaO2 may still be clinically indicated.

Reevaluation of the utilization of arterial blood gas analysis in the Intensive Care Unit: Effects on patient safety and patient outcome

2015 ◽  
Vol 30 (2) ◽  
pp. 438.e1-438.e5 ◽  
Author(s):  
Franziska E. Blum ◽  
Elisa Takalo Lund ◽  
Heather A. Hall ◽  
Allan D. Tachauer ◽  
Edgar G. Chedrawy ◽  
...  
Keyword(s):  
Patient Outcome ◽  
Intensive Care Unit ◽  
Patient Safety ◽  
Intensive Care ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Blood Gas ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Arterial Blood Gas Analysis
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