Document Detail


Validation of venous pCO2 to screen for arterial hypercarbia in patients with chronic obstructive airways disease.
MedLine Citation:
PMID:  15837016     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To validate a previously derived venous pCO2 (pvCO2) cut-off for ruling out arterial hypercarbia in patients with chronic obstructive pulmonary disease (COPD), matched arterial and venous blood gas samples were taken from a convenience sample of patients who presented to the Emergency Department (ED) with COPD deemed by their treating doctor to require arterial blood gas (ABG) analysis as part of their care. The screening cut-off was defined as pvCO2 of > 45 mm Hg and arterial hypercarbia was defined as arterial pCO2 (paCO2) of > 50 mm Hg. Descriptive statistics were employed. Sensitivity, specificity and negative predictive value were calculated. There were 112 patients enrolled in the study, of whom 107 had complete data for analysis. Forty-three patients had arterial hypercarbia (range of 51 to 90 mm Hg, median 60 mm Hg). All cases of arterial hypercarbia were detected by the screening cut-off (sensitivity 100%; 43/43; 95% CI 91-100%; specificity 47%, 95% CI 35-59%). The negative predictive value of pvCO2 < 45 mm Hg was 100% (30/30, 95% CI 89-100%). Assuming the ABG was performed to assess hypercarbia, 29% of ABGs potentially could have been avoided if a venous screening test was employed. In conclusion, pvCO2 can be used as a screening test for arterial hypercarbia, and if employed, can potentially reduce the requirement for ABG sampling.
Authors:
Anne-Maree Kelly; Debra Kerr; Paul Middleton
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Publication Detail:
Type:  Journal Article; Validation Studies    
Journal Detail:
Title:  The Journal of emergency medicine     Volume:  28     ISSN:  0736-4679     ISO Abbreviation:  J Emerg Med     Publication Date:  2005 May 
Date Detail:
Created Date:  2005-04-19     Completed Date:  2005-07-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8412174     Medline TA:  J Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  377-9     Citation Subset:  IM    
Affiliation:
Joseph Epstein Centre for Emergency Medicine Research, Footscray, Victoria, Australia.
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MeSH Terms
Descriptor/Qualifier:
Aged
Blood Gas Analysis / methods*,  standards
Carbon Dioxide / blood*
Humans
Hypercapnia / diagnosis*,  etiology
Partial Pressure
Predictive Value of Tests
Prospective Studies
Pulmonary Disease, Chronic Obstructive / blood,  complications*
Veins
Chemical
Reg. No./Substance:
124-38-9/Carbon Dioxide

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


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