Comparison and agreement between venous and arterial gas analysis in cardiopulmonary patients in Kashmir valley of the Indian subcontinent

Abstract

BACKGROUND:Arterial blood gas (ABG) analysis is routinely performed for sick patients but is fraught with complications, is painful, and is technically demanding.OBJECTIVE:To ascertain agreement between the arterial and peripheral venous measurement of pH, pCO2, pO2, and bicarbonate levels in sick patients with cardiopulmonary disorders in the valley of Kashmir in the Indian subcontinent, so as to use venous gas analysis instead of arterial for assessment of patients.SETTING:Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, a 650-bedded tertiary care hospital in North India located at an altitude of 1584 m.METHODS:One hundred patients who required ABG analysis were admitted. Peripheral venous blood was drawn within 5 min of an ABG measurement, and the samples analyzed immediately on a point of care automated ABG analyzer. Finger pulse oximetry was used to obtain oxygen (SpO2) saturation. Data were analyzed using Pearson correlation and bias (Bland Altman) methods.RESULTS:The venous measurements of pH, pCO2, pO2 and bicarbonate, and the digital oxygen saturation were highly correlated with their corresponding arterial measurements. Bland Altman plots demonstrated a high degree of agreement between the two corresponding sets of measurements with clinically acceptable differences. The difference in pO2 measurements was, however, higher (−22.34 ± 15.23) although the arterial saturation and finger oximetry revealed a good degree of agreement with clinically acceptable bias.CONCLUSION:Peripheral venous blood gas assessment in conjunction with finger pulse oximetry can obviate the routine use of arterial puncture in patients requiring ABG analysis.

Peripheral venous and arterial blood gas analysis in adults: are they comparable? A systematic review and meta‐analysis

“…Of these, 7695 were excluded as they failed to meet the inclusion criteria (most were not relevant to the study question as there was no direct comparison of VBG and ABG analyses, others were performed on paediatric populations or the VBG sample was central or mixed venous). The remaining 32 full‐text articles were examined for eligibility, and a further 14 studies were excluded (nine studies had incomplete data required for the meta‐analysis, four studies were not PVBG samples, and one study was performed on cardiopulmonary bypass) . The remaining 18 separate studies were included in the qualitative synthesis and contributed data to the meta‐analysis (Fig.…”

“…incomplete data required for the meta-analysis, four studies were not PVBG samples, and one study was performed on cardiopulmonary bypass). 6, 16 The remaining 18 separate studies were included in the qualitative synthesis and contributed data to the meta-analysis ( Fig. 1); 16 assessed PCO2, 15 assessed pH, and 11 assessed PO2.…”

Stress Hyperglycemia as Predictive Factor of Recurrence in Children with Febrile Seizures

“…Blood glucose, lactate, and parameters defining acid-base status (pH, pCO 2 , HCO 3 ) were documented for all venous blood samples. Current approaches envisage a cautionary view in evaluating the peripheral venous lactate instead of arterial lactate, especially for significant high value levels [25][26][27][28][29][30][31]. However, recent reviews on lactate measurement (arterial versus venous blood sampling) revealed very strong correlations between arterial and venous lactate concentrations [32].…”

Are arterial and venous samples clinically equivalent for the estimation of pH, serum bicarbonate and potassium concentration in critically ill patients?

“…The use of venous sampling in the management of diabetic ketoacidosis has been standard practice in paediatric patients for many years [2]. Although venous blood gas analysis has been recommended in adults for post‐diagnosis monitoring of acid‐base status [1,3], results from previous studies do not consistently suggest that the two sites can be used interchangeably [4–10]. Lack of duplication of each assay in these studies prevents assessment of the precision of the instruments used for the population studied, making it unclear whether perceived differences between sample sites in fact reflect instrument imprecision [11].…”