Document Detail


Hyperventilation and finger exercise increase venous-arterial Pco2 and pH differences.
MedLine Citation:
PMID:  19091262     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Since the invention of the pulse oximeter, physicians often or even routinely perform venous blood gas analysis (VBGA). However, it has not been generally agreed that the application of VBGA is practically meaningful in routine clinical situations such as in an ED.
METHODS: We measured venous-arterial Pco(2) difference ((v-a)Pco(2)) and arterial-venous pH difference ((a-v)pH), and analyzed the physiological factors that affect these differences in healthy volunteers and hyperventilation patients.
RESULTS: In healthy volunteers, both (v-a)Pco(2) and (a-v)pH increased during finger exercise or hyperventilation in an intensity-dependent manner. Doppler echography indicated that increases in (v-a)Pco(2) and (a-v)pH during hyperventilation are induced by reduction of peripheral blood flow. Approximately 40% of patients with untreated respiratory alkalosis were found to be incorrectly diagnosed if based only on VBGA.
CONCLUSIONS: It must be noted that VBGA may lead to overestimation of acidosis and to underestimation of respiratory alkalosis when extremities muscles are active or patients are hyperventilating. Physicians should keep these limitations in mind when conducting VBGA.
Authors:
Akira Umeda; Kazuteru Kawasaki; Tadashi Abe; Maki Watanabe; Akitoshi Ishizaka; Yasumasa Okada
Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  The American journal of emergency medicine     Volume:  26     ISSN:  1532-8171     ISO Abbreviation:  Am J Emerg Med     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2008-12-18     Completed Date:  2009-01-08     Revised Date:  2012-01-04    
Medline Journal Info:
Nlm Unique ID:  8309942     Medline TA:  Am J Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  975-80     Citation Subset:  IM    
Affiliation:
Department of Respiratory Medicine, Ohtawara Red Cross Hospital, Tochigi, Japan. aumeda@hf.catv.ne.jp
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MeSH Terms
Descriptor/Qualifier:
Acidosis / blood,  diagnosis
Adolescent
Adult
Aged
Alkalosis, Respiratory / blood,  diagnosis*
Blood Gas Analysis / methods*
Diagnostic Errors
Exercise / physiology
Female
Humans
Hydrogen-Ion Concentration
Hyperventilation / blood*
Male
Middle Aged
Young Adult
Comments/Corrections
Erratum In:
Am J Emerg Med. 2012 Jan;30(1):246

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


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