Document Detail


Correlation of central venous and arterial blood gas measurements in mechanically ventilated trauma patients.
MedLine Citation:
PMID:  16342377     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
HYPOTHESIS: Central venous blood gas (VBG) measurements of pH, PCO2, and base excess can be substituted for the same values obtained from an arterial blood gas (ABG) analysis in mechanically ventilated trauma patients, obviating the need for arterial puncture. DESIGN AND SETTING: Prospective comparison of 99 sets of VBGs and ABGs at a level 1 academic trauma center. PATIENTS: A consecutive sample of 25 trauma patients admitted to the intensive care unit who required mechanical ventilation and had both central venous and arterial catheters. MAIN OUTCOME MEASURES: Pearson correlations and Bland-Altman limits of agreement (LOAs) for pH, PCO2, and base excess values from each set of VBGs and ABGs. RESULTS: When VBG and ABG values were compared, pH had R = 0.92, P<.001, and 95% LOAs of -0.09 to 0.03; PCO2, R = 0.88, P<.001, and 95% LOAs of -2.2 to 10.9; and base excess, R = 0.96, P<.001, and 95% LOAs of -2.2 to 1.8. A receiver operating characteristic curve showed that a central venous PCO2 of 50 mm Hg had 100% sensitivity and 84% specificity for determining significant hypercarbia (arterial PCO2 > 50 mm Hg). CONCLUSIONS: Central venous and arterial PCO2, pH, and base excess values correlate well, but their LOAs represent clinically significant ranges that could affect management. Although VBGs cannot be substituted for ABGs in mechanically ventilated trauma patients during the initial phases of resuscitation, clinically reliable conclusions can be reached with VBG analysis.
Authors:
Darren J Malinoski; Samuel R Todd; Sue Slone; Richard J Mullins; Martin A Schreiber
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Archives of surgery (Chicago, Ill. : 1960)     Volume:  140     ISSN:  0004-0010     ISO Abbreviation:  Arch Surg     Publication Date:  2005 Nov 
Date Detail:
Created Date:  2005-12-07     Completed Date:  2006-01-12     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  9716528     Medline TA:  Arch Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1122-5     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, Oregon Health and Science University, Portland, USA. dmalinoski@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Blood Gas Analysis / methods*
Carbon Dioxide / blood
Humans
Hydrogen-Ion Concentration
Monitoring, Physiologic
Prospective Studies
ROC Curve
Respiration, Artificial*
Wounds and Injuries / blood*
Grant Support
ID/Acronym/Agency:
5 M01 RR000334/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
124-38-9/Carbon Dioxide
Comments/Corrections
Comment In:
Arch Surg. 2006 Jul;141(7):716; author reply 716   [PMID:  16847253 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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