Association of intraoperative blood gas analysis with patient outcome after adult cardiac surgery

Abstract Background: The associations of the different blood gas parameters from different blood samples harvested at different stages during adult cardiac surgery with the postoperative outcomes are inadequately studied. Methods: Adult patients undergoing elective cardiac surgery with cardiopulmonary bypass (CPB) participated in this prospective observational study. Blood gas parameters from arterial, central venous, and jugular bulb venous blood samples harvested simultaneously at pre-determined time points (baseline with the patient awake, post-anesthesia induction but before CPB, during CPB at 30°C, during CPB at 37°C (rewarming), and at the end of surgery) were correlated with postoperative outcomes including the length of mechanical ventilation (LMV), intensive care unit stay (LICU), hospital stay (LOH), and major organ morbidity and mortality. Results: Data from 193 patients were analyzed. Multiple parameters of different blood harvested at different stages significantly correlated with one or more outcome measures based on univariate analysis (p < 0.05). However, only the jugular bulb venous blood pH and carbon dioxide tension and the central venous blood pH at the end of surgery (pHcv-end) were significantly correlated with LMV, LICU, and LOH (p < 0.05). A more alkaline blood correlated with more favorable outcomes. After adjusting for age, surgical time, and total intravenous volume administered, multivariate analysis showed that only pHcv-end remained independently associated with LMV and LICU (p < 0.05). Conclusion: More alkaline blood, especially the central venous blood at the end of surgery, is associated with more favorable outcomes after adult cardiac surgery. Trial registration ChiCTR-POC-17013942, Date of registration December 15, 2017.

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Association of intraoperative blood gas analysis with patient outcome after adult cardiac surgery

10.21203/rs.2.1748/v1 ◽

2019 ◽

Author(s):

Shaopeng Gang ◽

Ling Jiang ◽

Kaiyun Fang ◽

Xiulun Liu ◽

Daokang Xiang ◽

...

Keyword(s):

Cardiac Surgery ◽

Venous Blood ◽

Postoperative Outcomes ◽

Blood Gas ◽

Central Venous ◽

Blood Samples ◽

Central Venous Blood ◽

Blood Ph ◽

Blood Gas Parameters ◽

Adult Cardiac Surgery

Abstract Background: The associations of the different blood gas parameters from different blood samples harvested at different stages during adult cardiac surgery with the postoperative outcomes are inadequately studied. Methods: Adult patients undergoing elective cardiac surgery with cardiopulmonary bypass (CPB) participated in this prospective observational study. Blood gas parameters from arterial, central venous, and jugular venous blood samples harvested simultaneously at pre-determined time points (baseline with the patient awake, post-anesthesia induction but before CPB, during CPB at 30°C, during CPB at 37°C (rewarming), and at the end of surgery) were correlated with postoperative outcomes including the length of mechanical ventilation (LMV), intensive care unit stay (LICU), hospital stay (LOH), and major organ morbidity and mortality. Results: Data from 193 patients were analyzed. Multiple parameters of different blood harvested at different stages significantly correlated with one or more outcome measures based on univariate analysis (p < 0.05). However, only the jugular venous blood pH and carbon dioxide tension and the central venous blood pH at the end of surgery (pHcv-end) were significantly correlated with LMV, LICU, and LOH (p < 0.05). A more alkaline blood correlated with more favorable outcomes. After adjusting for age, surgical time, and total intravenous volume administered, multivariate analysis showed that only pHcv-end remained independently associated with LMV and LICU (p < 0.05). Conclusion: More alkaline blood, especially the central venous blood at the end of surgery, is associated with more favorable outcomes after adult cardiac surgery. Trial registration ChiCTR-POC-17013942, Date of registration December 15, 2017.

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Predictive factors for restoration of heart beat in cardiopulmomonary arrest cases-Blood gas parameters, potassium and lactate in the central venous blood.

Nihon Kyukyu Igakukai Zasshi ◽

10.3893/jjaam.7.281 ◽

1996 ◽

Vol 7 (6) ◽

pp. 281-291

Author(s):

Tomomi Ohishi

Keyword(s):

Predictive Factors ◽

Venous Blood ◽

Heart Beat ◽

Blood Gas ◽

Central Venous ◽

Central Venous Blood ◽

Blood Gas Parameters

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The Accuracy of the Central Venous Blood Gas for Acid-Base Monitoring

Journal of Intensive Care Medicine ◽

10.1177/0885066609356164 ◽

2009 ◽

Vol 25 (2) ◽

pp. 104-110 ◽

Cited By ~ 25

Author(s):

Allan J. Walkey ◽

Harrison W. Farber ◽

Charles O'Donnell ◽

Howard Cabral ◽

Janet S. Eagan ◽

...

Keyword(s):

Venous Blood ◽

Blood Gas ◽

Central Venous ◽

Acid Base ◽

Central Venous Blood ◽

Venous Blood Gas

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Comparative study of bedside and laboratory measurements of hemoglobin

American Journal of Critical Care ◽

10.4037/ajcc1996.5.6.427 ◽

1996 ◽

Vol 5 (6) ◽

pp. 427-432 ◽

Cited By ~ 7

Author(s):

DA Krenzischek ◽

FV Tanseco

Keyword(s):

Venous Blood ◽

Hemoglobin Level ◽

Johns Hopkins Hospital ◽

Postanesthesia Care Unit ◽

Laboratory Measurements ◽

Central Venous ◽

Blood Samples ◽

Central Venous Blood ◽

Arterial Blood ◽

Group I

OBJECTIVE: The purpose of this study was to examine the effects of variations in technique on measurements of hemoglobin level done at the bedside and to compare these results with laboratory measurements of hemoglobin. DESIGN: In accordance with hospital policy, procedure, and protocol, various techniques were used to obtain samples of capillary and venous blood and of blood from arterial and central venous catheters. Levels of hemoglobin were measured at the bedside and in the laboratory, and the results were compared. SETTING: The Johns Hopkins Hospital adult postanesthesia care unit. SAMPLE: A total of 187 blood samples were obtained from 62 adults who had undergone general surgery. Group I comprised 20 subjects with capillary and venous blood samples. Group II comprised 21 subjects with arterial blood samples. Group III comprised 21 subjects with central venous blood samples. RESULTS: The results showed that the amount of blood to be discarded before obtaining samples of arterial and central venous blood need not be any larger than double the dead space of the catheter, and that shaking the blood sample for 10 seconds was sufficient to mix the sample before measurement of hemoglobin levels. Results of bedside and laboratory measurements of hemoglobin level were comparable. CONCLUSION: Bedside measurement of hemoglobin increases efficiency in patient care, decreases risk of blood-transmitted infection for staff, and decreases cost to the patient. However, the persons who perform the assay must be responsible in adhering to the standard of practice to minimize errors in the measurements.

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Central venous blood gas and acid-base status in conscious dogs and cats

Journal of Veterinary Medical Science ◽

10.1292/jvms.14-0503 ◽

2015 ◽

Vol 77 (7) ◽

pp. 865-869 ◽

Cited By ~ 4

Author(s):

Jun TAMURA ◽

Takaharu ITAMI ◽

Tomohito ISHIZUKA ◽

Sho FUKUI ◽

Kenjirou MIYOSHI ◽

...

Keyword(s):

Venous Blood ◽

Conscious Dogs ◽

Blood Gas ◽

Central Venous ◽

Acid Base ◽

Central Venous Blood ◽

Acid Base Status ◽

Venous Blood Gas

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Correlation and agreement between arterial and central venous blood pH, PO2, PCO2 and HCO3- values of mechanically ventilated patients in intensive care unit: A prospective observational study☆,☆☆

Colombian Journal of Anesthesiology ◽

10.1097/01819236-201341030-00005 ◽

2013 ◽

Vol 41 (3) ◽

pp. 190-195

Author(s):

Mohd Sabihul Islam ◽

Moied S. Ahmed ◽

S. Bano ◽

Abu Nadeem ◽

Mozammil Shafi

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Prospective Observational Study ◽

Venous Blood ◽

Central Venous ◽

Mechanically Ventilated ◽

Mechanically Ventilated Patients ◽

Central Venous Blood ◽

Blood Ph ◽

Ventilated Patients

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Intraocular pressure and its correlation with blood gas parameters in crested caracaras (Caracara plancus) anesthetized with isoflurane and sevoflurane

Arquivo Brasileiro de Medicina Veterinária e Zootecnia ◽

10.1590/s0102-09352008000600023 ◽

2008 ◽

Vol 60 (6) ◽

pp. 1461-1467

Author(s):

A.P. Ribeiro ◽

S.N. Vitaliano ◽

R. Thiesen ◽

A. Escobar ◽

J.P. Duque Ortiz ◽

...

Keyword(s):

Carbon Dioxide ◽

Intraocular Pressure ◽

Brachial Artery ◽

Carbon Dioxide Partial Pressure ◽

Blood Gas ◽

Blood Samples ◽

Time Points ◽

Blood Ph ◽

Arterial Ph ◽

Blood Gas Parameters

The intraocular pressure (IOP) and its correlations with arterial carbon dioxide partial pressure (PaCO2) and arterial pH were studied in five crested caracaras (Caracara plancus) anesthetized with isoflurane (ISO) and sevoflurane (SEV). Baseline IOP values were measured in both eyes (M0). Brachial artery was previously catheterized to obtain blood gas and cardiorespiratory analysis. Anesthesia was induced with 5% ISO and maintained with 2.5% for 40 minutes. IOP measurements and blood samples were evaluated in different moments until the end of the procedure. After recovering, a second anesthesia was induced with 6% SEV and maintained with 3.5%. Parameters were evaluated at the same time points of the previous procedure. IOP reduced significantly (P= 0.012) from M0 at all time points and no significative changes were observed between ISO and SEV anesthesias. Correlation between IOP and PaCO2 and between PIO and blood pH were found only for SEV. IOP and blood pH decreased in parallel with IOP, whereas values of PaCO2 increased in caracaras anesthetized with isoflurane and sevoflurane.

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