| Hyperventilation and finger exercise increase venous-arterial Pco2 and pH differences. | |
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MedLine Citation:
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PMID: 19091262 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Akira Umeda; Kazuteru Kawasaki; Tadashi Abe; Maki Watanabe; Akitoshi Ishizaka; Yasumasa Okada |
Publication Detail:
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Type: Clinical Trial; Journal Article |
Journal Detail:
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Title: The American journal of emergency medicine Volume: 26 ISSN: 1532-8171 ISO Abbreviation: Am J Emerg Med Publication Date: 2008 Nov |
Date Detail:
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Created Date: 2008-12-18 Completed Date: 2009-01-08 Revised Date: 2012-01-04 |
Medline Journal Info:
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Nlm Unique ID: 8309942 Medline TA: Am J Emerg Med Country: United States |
Other Details:
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Languages: eng Pagination: 975-80 Citation Subset: IM |
Affiliation:
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Department of Respiratory Medicine, Ohtawara Red Cross Hospital, Tochigi, Japan. aumeda@hf.catv.ne.jp |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Acidosis
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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:
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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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