Blood Gas Analyzed

7/24/2019 Blood Gas Analyzed

1/15

.

LASMONO SUSANTO

POSGRADUATE BIOMEDICAL SCIENCE

UNIVERSITY SUMATERA UTARA

FACULTY OF MEDICINE

AGREEMENT BETWEEN CENTRAL

VENOUS AND ARTERIAL BLOOD

GAS

MEASUREMENTS IN THEINTENSIVE CARE UNIT


2/15

Introductions

BLOOD GAS

MEASUREMENTS

O2

saturation

pCO3

HCO3

PO2

pH

determine the

acid-base and respiratory status of patients;


3/15

Background

arterial injury, thrombosis or embolization, hematoma, aneurysm formation, and

reflex sympatheticdystrophy

Venous blood gas (VBG) is arelatively safer procedur for pH

status


4/15

Background

no study hasobtainedmultiple pairedABG and VBG

samples

No evaluatewhether theagreementbetweenABG andVBG values

No values isacceptablethroughoutpH andespiratoryconditions .


5/15

prospective trial to assess the agreement betweenarterial and VBG measurements

- Data comparing central and peripheralVBG values were also obtained.

- Paired central and peripheral venoussamples were drawn within 2 minutes ofone another in ICU patients with bothcentral venous lines and peripheralintravenous lines already in place.-

Methods


6/15

ResultsThe study involved 40 patients with a total of 221paired ABG-VBG samples.


7/15

Bland-Altman plot of arterial and central venous blood pHshowing the regression line (solid line) and the 95% limits ofagreement of 0.028 to 0.081 (dotted lines) for the A-V

difference.r

0.296,R

2 0.088.


8/15

Bland-Altman plot of arterial and central venous blood HCO3showing the regression line (solid line) and the 95% limits ofagreement of 4.0 to 2.4 mEq/L (dotted lines) for the A-Vdifference.r 0.136, R2 0.018.


9/15

Bland-Altman plot of arterial and central venous blood Pco2showing the regression line (solid line) and the 95% limits ofagreement of 12.3 to 4.8 mmHg (dotted lines) for the A-Vdifference.r 0.01, R2 0.0001.


10/15

Correlation between central venous andarterial blood gas values for pH. R2 0.95.


11/15

Correlation between central venous and arterialblood gas values for Pco2. R2 0.88.


12/15

Correlation between central venous and arterial bloodgas values for HCO3. R2 0.95. Clin J Am


13/15

Peripheral or central venous pH, Pco2 andbicarbonate can replace their arterial

equivalents in many clinical contexts in the ICU.

Further work needs to be done to define betterthe relationship between ABG and VBG valuesin low-cardiac-output states.

Conclusions:


14/15

Richard Treger, Shahriar Pirouz, Nader Kamangar, and DalilaCorry, Clin J Am Soc Nephrol 5: 390394, 2010.

References:


15/15

Thank you

Question anddiscution ?

Blood Gas Analyzed

Documents

Transcript of Blood Gas Analyzed