Document Detail


Agreement between central venous and arterial blood gas measurements in the intensive care unit.
MedLine Citation:
PMID:  20019117     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVES: Venous blood gas (VBG) analysis is a safer procedure than arterial blood gas (ABG) analysis and may be an alternative for determining acid-base status. The objective of this study was to examine the agreement between ABG and central VBG samples for all commonly used parameters in a medical intensive care unit (ICU) population.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We performed a single-center, prospective trial to assess the agreement between arterial and central VBG measurements in a medical ICU. Adult patients who were admitted to the ICU and required both a central venous line and an arterial line were enrolled. When an ABG was performed, a central venous sample was obtained to examine the agreement among the pH, Pco(2), and bicarbonate. Data comparing central and peripheral VBG values were also obtained.
RESULTS: The mean arterial minus venous difference for pH, Pco(2), and bicarbonate was 0.027, -3.8, and -0.80, respectively. Bland-Altman plots for agreement of pH, Pco(2), and bicarbonate showed 95% limits of agreement of -0.028 to 0.081, -12.3 to 4.8, and -4.0 to 2.4, respectively. Regression equations were derived to predict arterial values from venous values as follows: Arterial pH = -0.307 + 1.05 x venous pH, arterial Pco(2) = 0.805 + 0.936 x venous Pco(2), and arterial bicarbonate = 0.513 + 0.945 x venous bicarbonate. The mean central minus peripheral differences for pH, Pco(2), and bicarbonate were not clinically important.
CONCLUSIONS: Peripheral or central venous pH, Pco(2), and bicarbonate can replace their arterial equivalents in many clinical contexts encountered in the ICU.
Authors:
Richard Treger; Shahriar Pirouz; Nader Kamangar; Dalila Corry
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-12-17
Journal Detail:
Title:  Clinical journal of the American Society of Nephrology : CJASN     Volume:  5     ISSN:  1555-905X     ISO Abbreviation:  Clin J Am Soc Nephrol     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-08     Completed Date:  2010-05-28     Revised Date:  2011-07-25    
Medline Journal Info:
Nlm Unique ID:  101271570     Medline TA:  Clin J Am Soc Nephrol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  390-4     Citation Subset:  IM    
Affiliation:
West LA Veterans Affairs Medical Center, 11301 Wilshire Boulevard, W111A, Los Angeles, CA 90073, USA. richard.treger@va.gov
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Bicarbonates / blood*
Biological Markers / blood
Blood Gas Analysis / methods*
Carbon Dioxide / blood*
Catheterization, Central Venous*
Catheterization, Peripheral*
Female
Humans
Hydrogen-Ion Concentration
Intensive Care
Intensive Care Units*
Linear Models
Male
Middle Aged
Predictive Value of Tests
Prospective Studies
Reproducibility of Results
Chemical
Reg. No./Substance:
0/Bicarbonates; 0/Biological Markers; 124-38-9/Carbon Dioxide
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