Document Detail


Prospective correlation of arterial vs venous blood gas measurements in trauma patients.
MedLine Citation:
PMID:  22169587     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The objective of this study is to assess if venous blood gas (VBG) results (pH and base excess [BE]) are numerically similar to arterial blood gas (ABG) in acutely ill trauma patients.
METHODS: We prospectively correlated paired ABG and VBG results (pH and BE) in adult trauma patients when ABG was clinically indicated. A priori consensus threshold of clinical equivalence was set at ± less than 0.05 pH units and ± less than 2 BE units. We hypothesized that ABG results could be predicted by VBG results using a regression equation, derived from 173 patients, and validated on 173 separate patients.
RESULTS: We analyzed 346 patients and found mean arterial pH of 7.39 and mean venous pH of 7.35 in the derivation set. Seventy-two percent of the paired sample pH values fell within the predefined consensus equivalence threshold of ± less than 0.05 pH units, whereas the 95% limits of agreement (LOAs) were twice as wide, at -0.10 to 0.11 pH units. Mean arterial BE was -2.2 and venous BE was -1.9. Eighty percent of the paired BE values fell within the predefined ± less than 2 BE units, whereas the 95% LOA were again more than twice as wide, at -4.4 to 3.9 BE units. Correlations between ABG and VBG were strong, at r(2) = 0.70 for pH and 0.75 for BE.
CONCLUSION: Although VBG results do correlate well with ABG results, only 72% to 80% of paired samples are clinically equivalent, and the 95% LOAs are unacceptably wide. Therefore, ABG samples should be obtained in acutely ill trauma patients if accurate acid-base status is required.
Authors:
Scott E Rudkin; Christopher A Kahn; Jennifer A Oman; Matthew O Dolich; Shahram Lotfipour; Stephanie Lush; Marla Gain; Charmaine Firme; Craig L Anderson; Mark I Langdorf
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2011-12-12
Journal Detail:
Title:  The American journal of emergency medicine     Volume:  30     ISSN:  1532-8171     ISO Abbreviation:  Am J Emerg Med     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-01     Completed Date:  2013-01-29     Revised Date:  2014-04-08    
Medline Journal Info:
Nlm Unique ID:  8309942     Medline TA:  Am J Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1371-7     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Elsevier Inc. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Alkalosis / blood
Arteries*
Blood Gas Analysis / methods*
Female
Humans
Hydrogen-Ion Concentration
Injury Severity Score
Male
Middle Aged
Prospective Studies
Trauma Centers
Veins*
Wounds and Injuries / blood*
Young Adult
Grant Support
ID/Acronym/Agency:
M01 RR000827-30/RR/NCRR NIH HHS; M01 RR00827/RR/NCRR NIH HHS
Comments/Corrections

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