| Comparison of simultaneously obtained arterial and capillary blood gases in pediatric intensive care unit patients. | |
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MedLine Citation:
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PMID: 9366777 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To determine whether capillary blood gas measurements provide a clinically acceptable estimate of arterial pH, PCO2, and PO2. DESIGN: Prospective convenience sample. SETTING: Pediatric intensive care unit at a referral children's hospital. PATIENTS: Fifty children > 1 month of age with indwelling arterial catheters. INTERVENTIONS: A local anesthetic was applied to the third finger of the hand contralateral to a radial artery catheter. After 90 mins, simultaneous arterial and capillary blood gases were drawn. MEASUREMENTS AND MAIN RESULTS: Arterial and capillary pH, PcO2, and PO2 were measured. Heart rate and Wong/Baker faces score were noted before and during capillary blood gas collection to assess discomfort associated with blood collection. There was a strong correlation between capillary and arterial pH (r2 = .903, p < .0001). The relative average bias of the capillary pH was 0.009, with capillary lower than arterial and 95% limits of agreement of +/- 0.032. In all patients, the absolute value of the difference between arterial and capillary pH was < or = 0.05. There was a strong correlation between arterial and capillary PCO2 (r2 = .955, p < .0001). The relative average bias of the capillary PCO2 was 1.6 torr (0.21 kPa), with capillary higher than arterial and 95% limits of agreement of +/- 4.5 torr (+/- 0.6 kPa). In two of 50 patients, the absolute value of the difference between arterial and capillary PCO2 was > 6.5 torr (> 0.87 kPa). Despite a statistically significant correlation between capillary and arterial PO2 (r2 = .358, p < .0001), the absolute value of the difference between arterial and capillary PO2 was > 6.5 torr (> 0.87 kPa) in 42 of 50 patients. Pain, endotracheal intubation, vasoactive drips, or pharmacologic paralysis did not affect accuracy of the capillary pH or PCO2. CONCLUSIONS: Capillary blood gases accurately reflect arterial pH and PCO2 in most pediatric intensive care unit patients. Capillary samples did not significantly underestimate arterial hypercarbia or acidosis. This conservative reflection of metabolic status may be particularly useful in hemodynamically stable patients with mild-to-moderate lung disease. |
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Authors:
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A M Harrison; J M Lynch; J M Dean; M K Witte |
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Critical care medicine Volume: 25 ISSN: 0090-3493 ISO Abbreviation: Crit. Care Med. Publication Date: 1997 Nov |
Date Detail:
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Created Date: 1997-12-09 Completed Date: 1997-12-09 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0355501 Medline TA: Crit Care Med Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1904-8 Citation Subset: AIM; IM |
Affiliation:
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Department of Pediatrics, University of Utah, Primary Children's Medical Center, Salt Lake City, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Acidosis
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blood Arteries* Blood Gas Analysis / methods Capillaries* Carbon Dioxide / blood* Child Child, Preschool Humans Hydrogen-Ion Concentration Infant Intensive Care Units, Pediatric Oxygen / blood* Predictive Value of Tests Prospective Studies |
| Chemical | |
Reg. No./Substance:
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124-38-9/Carbon Dioxide; 7782-44-7/Oxygen |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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