Peripheral venous blood gases and pulse-oximetry in acute cardiogenic pulmonary oedema

Abstract

In patients with cardiogenic pulmonary oedema, arterial blood gas disturbances may be estimated from peripheral venous samples. By monitoring SpO2 simultaneously, arterial punctures could often be avoided.

Recommendations on pre-hospital and early hospital management of acute heart failure: a consensus paper from the Heart Failure Association of the European Society of Cardiology, the European Society of Emergency Medicine and the Society of Academic Emergency Medicine – short version

“…As shown in Figure 3, arterial blood gases are not routinely indicated and should be restricted to patients in whom oxygenation cannot be reliably assessed by pulse oximetry. In case of persistent respiratory distress, despite initial therapy with oxygen and/or non-invasive ventilation, venous blood gas analysis should be obtained to detect respiratory or metabolic acidosis 23 . We recommend measuring creatinine, BUN and electrolytes every 1-2 days while in the hospital, and creatinine, BUN, electrolytes and natriuretic peptides before discharge from the hospital.…”

Comprehensive in‐hospital monitoring in acute heart failure: applications for clinical practice and future directions for research. A statement from the Acute Heart Failure Committee of the Heart Failure Association (HFA) of the European Society of Cardiology (ESC)

“…The ratio of pO 2 /fraction of inspired oxygen gives a better impression of the adequacy of pulmonary gas exchange than pO 2 alone. A high correlation has been demonstrated between pCO 2 and pH measured in venous and arterial blood; thus, venous blood gas analysis is a very good alternative method, especially in those patients in whom pulse oximetry is over 90%.…”

Organ dysfunction, injury and failure in acute heart failure: from pathophysiology to diagnosis and management. A review on behalf of the Acute Heart Failure Committee of the Heart Failure Association (HFA) of the European Society of Cardiology (ESC)

“…Acute pulmonary oedema is characterized by increased work of breathing with a respiratory rate of >25 breaths/min and peripheral oxygen saturation by pulse oximetry (SpO 2 ) of <90% . Monitoring of SpO 2 provides reliable information about arterial oxygen saturation (SaO 2 ) . Respiratory rate and SpO 2 also closely correlate with AHF severity and mortality.…”

“…Blood gas analysis of venous samples can be useful for a rapid assessment of acid–base status . Arterial blood gas analysis is indicated in patients with suspected severe hypoxaemia, hypoventilation and cardiogenic shock, high risk or suspicion of hypercapnia, or in whom oxygenation cannot be assessed reliably by pulse oximetry .…”