Eli Zeserson1, Ben Goodgame1, J Daniel Hess1, Kristine Schultz1, Cynthia Hoon1, Keith Lamb2, Vinay Maheshwari3, Steven Johnson4, Mia Papas5, James Reed1, Michael Breyer6. 1. 1 Department of Emergency Medicine, Christiana Care Health System, Newark, DE, USA. 2. 2 Department of Respiratory Care, Unity Point Health, Des Moines, IA, USA. 3. 3 Department of Medicine, Christiana Care Health System, Newark, DE, USA. 4. 4 Department of Surgery, Capital Health, Trenton, NJ, USA. 5. 5 Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE, USA. 6. 6 Department of Emergency Medicine, Denver Health Medical Center, Denver, CO, USA.
Abstract
RATIONALE: Blood gas analysis is often used to assess acid-base, ventilation, and oxygenation status in critically ill patients. Although arterial blood gas (ABG) analysis remains the gold standard, venous blood gas (VBG) analysis has been shown to correlate with ABG analysis and has been proposed as a safer less invasive alternative to ABG analysis. OBJECTIVE: The purpose of this study was to evaluate the correlation of VBG analysis plus pulse oximetry (SpO2) with ABG analysis. METHODS: We performed a prospective cohort study of patients in the emergency department (ED) and intensive care unit (ICU) at a single academic tertiary referral center. Patients were eligible for enrollment if the treating physician ordered an ABG. Statistical analysis of VBG, SpO2, and ABG data was done using paired t test, Pearson χ2, and Pearson correlation. MAIN RESULTS: There were 156 patients enrolled, and 129 patients completed the study. Of the patients completing the study, 53 (41.1%) were in the ED, 41 (31.8%) were in the medical ICU, and 35 (27.1%) were in the surgical ICU. The mean difference for pH between VBG and ABG was 0.03 (95% confidence interval: 0.03-0.04) with a Pearson correlation of 0.94. The mean difference for pCO2 between VBG and ABG was 4.8 mm Hg (95% confidence interval: 3.7-6.0 mm Hg) with a Pearson correlation of 0.93. The SpO2 correlated well with PaO2 (the partial pressure of oxygen in arterial blood) as predicted by the standard oxygen-hemoglobin dissociation curve. CONCLUSION: In this population of undifferentiated 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. The combination of VBG analysis plus SpO2 provided accurate information on acid-base, ventilation, and oxygenation status for undifferentiated critically ill patients in the ED and ICU.
RATIONALE: Blood gas analysis is often used to assess acid-base, ventilation, and oxygenation status in critically ill patients. Although arterial blood gas (ABG) analysis remains the gold standard, venous blood gas (VBG) analysis has been shown to correlate with ABG analysis and has been proposed as a safer less invasive alternative to ABG analysis. OBJECTIVE: The purpose of this study was to evaluate the correlation of VBG analysis plus pulse oximetry (SpO2) with ABG analysis. METHODS: We performed a prospective cohort study of patients in the emergency department (ED) and intensive care unit (ICU) at a single academic tertiary referral center. Patients were eligible for enrollment if the treating physician ordered an ABG. Statistical analysis of VBG, SpO2, and ABG data was done using paired t test, Pearson χ2, and Pearson correlation. MAIN RESULTS: There were 156 patients enrolled, and 129 patients completed the study. Of the patients completing the study, 53 (41.1%) were in the ED, 41 (31.8%) were in the medical ICU, and 35 (27.1%) were in the surgical ICU. The mean difference for pH between VBG and ABG was 0.03 (95% confidence interval: 0.03-0.04) with a Pearson correlation of 0.94. The mean difference for pCO2 between VBG and ABG was 4.8 mm Hg (95% confidence interval: 3.7-6.0 mm Hg) with a Pearson correlation of 0.93. The SpO2 correlated well with PaO2 (the partial pressure of oxygen in arterial blood) as predicted by the standard oxygen-hemoglobin dissociation curve. CONCLUSION: In this population of undifferentiated 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. The combination of VBG analysis plus SpO2 provided accurate information on acid-base, ventilation, and oxygenation status for undifferentiated critically ill patients in the ED and ICU.
Entities:
Keywords:
blood gas analysis; critical care; oximetry
Authors: J Hope Kilgannon; Alan E Jones; Nathan I Shapiro; Mark G Angelos; Barry Milcarek; Krystal Hunter; Joseph E Parrillo; Stephen Trzeciak Journal: JAMA Date: 2010-06-02 Impact factor: 56.272
Authors: Joshua F Ihle; Stephen Bernard; Michael J Bailey; David V Pilcher; Karen Smith; Carlos D Scheinkestel Journal: Crit Care Resusc Date: 2013-09 Impact factor: 2.159
Authors: Rinaldo Bellomo; Michael Bailey; Glenn M Eastwood; Alistair Nichol; David Pilcher; Graeme K Hart; Michael C Reade; Moritoki Egi; D James Cooper Journal: Crit Care Date: 2011-03-08 Impact factor: 9.097
Authors: Guido Michels; Tobias Wengenmayer; Christian Hagl; Christian Dohmen; Bernd W Böttiger; Johann Bauersachs; Andreas Markewitz; Adrian Bauer; Jan-Thorsten Gräsner; Roman Pfister; Alexander Ghanem; Hans-Jörg Busch; Uwe Kreimeier; Andreas Beckmann; Matthias Fischer; Clemens Kill; Uwe Janssens; Stefan Kluge; Frank Born; Hans Martin Hoffmeister; Michael Preusch; Udo Boeken; Reimer Riessen; Holger Thiele Journal: Clin Res Cardiol Date: 2018-09-04 Impact factor: 5.460
Authors: G Michels; T Wengenmayer; C Hagl; C Dohmen; B W Böttiger; J Bauersachs; A Markewitz; A Bauer; J-T Gräsner; R Pfister; A Ghanem; H-J Busch; U Kreimeier; A Beckmann; M Fischer; C Kill; U Janssens; S Kluge; F Born; H M Hoffmeister; M Preusch; U Boeken; R Riessen; H Thiele Journal: Med Klin Intensivmed Notfmed Date: 2018-09 Impact factor: 0.840
Authors: G Michels; T Wengenmayer; C Hagl; C Dohmen; B W Böttiger; J Bauersachs; A Markewitz; A Bauer; J-T Gräsner; R Pfister; A Ghanem; H-J Busch; U Kreimeier; A Beckmann; M Fischer; C Kill; U Janssens; S Kluge; F Born; H M Hoffmeister; M Preusch; U Boeken; R Riessen; H Thiele Journal: Anaesthesist Date: 2018-08 Impact factor: 1.041
Authors: Jonghwan Shin; Yong Su Lim; Kyuseok Kim; Hui Jai Lee; Se Jong Lee; Euigi Jung; Kyoung Min You; Hyuk Jun Yang; Jin Joo Kim; Joonghee Kim; You Hwan Jo; Jae Hyuk Lee; Seong Youn Hwang Journal: Crit Care Date: 2017-12-21 Impact factor: 9.097
Authors: Jason Y Adams; Angela J Rogers; Alejandro Schuler; Gregory P Marelich; Jennifer M Fresco; Sandra L Taylor; Albert W Riedl; Jennifer M Baker; Gabriel J Escobar; Vincent X Liu Journal: Perm J Date: 2020-01-31
Authors: Ervigio Corral Torres; Alberto Hernández-Tejedor; Rosa Suárez Bustamante; Ramón de Elías Hernández; Isabel Casado Flórez; Antonio San Juan Linares Journal: Crit Care Date: 2020-02-22 Impact factor: 9.097
Authors: Balakrishnan Ashokka; May-Han Loh; Cher Heng Tan; Lin Lin Su; Barnaby Edward Young; David Chien Lye; Arijit Biswas; Sebastian E Illanes; Mahesh Choolani Journal: Am J Obstet Gynecol Date: 2020-04-10 Impact factor: 10.693