Small Blood-Samples From Ear-Lobe Puncture???a Substitute for Arterial Puncture

Langlands, Jean H. M.; Hamilton, William K.

doi:10.1097/00132586-196608000-00009

Cited by 2 publications

(5 citation statements)

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“…Numerous studies published many years ago concluded that the method using arterialized earlobe blood for PO 2 and PCO 2 analysis at rest was accurate enough to replace arterial blood samples for clinical purposes [1,[3][4][5][6][7]. However, the validity of this method has been discussed in two recent studies [10,11] showing with the analysis of BLAND and ALTMAN [9] that PO 2 was usually lower in earlobe than in arterial blood, and that the limits of agreement were wide between the two methods.…”

Section: Discussionmentioning

confidence: 99%

“…The accepted technique established in clinical practice is blood sampling by direct arterial puncture. In the 1960s, it was proposed that blood gas values could be measured using arterialized earlobe blood samples [1]. This method is thought to be easier and less painful than direct arterial puncture [2].…”

mentioning

confidence: 99%

“…Initial [1,[3][4][5][6][7] or more recent [8] studies have concluded that the earlobe method might be accurate enough to replace arterial blood samples for clinical purposes. This contention is based mainly on positive and strong correlations that have been found between the two methods.…”

mentioning

confidence: 99%

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Blood gas measurement during exercise: a comparative study between arterialized earlobe sampling and direct arterial puncture in adults

Fajac¹,

Texereau²,

Rivoal³

et al. 1998

Eur Respir J

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Sampling arterialized earlobe blood is thought to be easier and less painful than direct arterial puncture, and to allow measurement of blood gas values during exercise without the need to insert an arterial cannula. However, arterialized earlobe oxygen tension (PO2) often underestimates arterial PO2 at rest, and is not fully validated during exercise. We have therefore conducted a prospective study to compare values of PO2 and carbon dioxide tension (PCO2) and the discomfort experienced by adult subjects undergoing the two methods of blood sampling during exercise. Seventy consecutive adult patients were studied. Blood samples were drawn simultaneously from the radial artery and arterialized earlobe of each patient during the last minute of an 8 min exercise. Values of PO2 and PCO2 were measured by means of blood gas electrodes. The correlation coefficients between the two samples were 0.92 for PO2 and 0.91 for PCO2. However, the bias and the limits of agreement between the two methods were wide for PO2 (mean+/-2SD of the differences between the two methods: 0.63+/-1.50 kPa (4.7+/-11.2 mmHg)). The bias and the limits of agreement were smaller for PCO2. Patients felt that the earlobe method was not associated with less discomfort than radial artery puncture. We conclude that arterialized earlobe blood oxygen tension is not a good substitute for arterial oxygen tension during exercise, and should not be used to assess arterial oxygen tension in adults during exercise.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Blood gas measurement during exercise: a comparative study between arterialized earlobe sampling and direct arterial puncture in adults

Fajac¹,

Texereau²,

Rivoal³

et al. 1998

Eur Respir J

View full text Add to dashboard Cite

show abstract

“…The use of arterialised earlobe blood sample for acid base status evaluation has been proposed almost 60 years back. [3] Techniques for sampling arterialised capillary blood from the finger pulp and the earlobe were described over twenty years ago. Being less invasive and easily accessible, arterialised ear lobe blood does not necessitate the risks of arterial punctures.…”

Section: Correlation Coefficient Of Arterial and Capillary Blood Gas mentioning

confidence: 99%

“…Based on the postulation that provided sufficient vasodilatation can be attained locally using topical vasoactive cream on the earlobe, the arterialised earlobe oxygen tension mimics the arterial oxygen tension due to confluence of arterial and venous oxygen tension. [4] Still, even with resemblance depicted between arterial and earlobe sample values in normal subjects, this technique is not commonly sought due to lack of awareness and dubiety regarding its accuracy [5] Initial [3,6,7] or more recent [5] studies have concluded that the earlobe blood sampling might be authentic enough to replace arterial blood samples for clinical purposes. This inference is based mainly on positive and strong correlations that have been found between the two methods.…”

Section: Correlation Coefficient Of Arterial and Capillary Blood Gas mentioning

confidence: 99%

Comparison and Correlation Between Arterial and Capillary Blood Gas Values in Mechanically Ventilated Adults

Rath¹,

Pati²,

Mishra³

2018

jemds

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BACKGROUND The essence of critical care medicine is the application of physiological principles to the care of seriously ill patients. Arterial puncture apart from being painful and technically difficult carries the risk of complications like local haematoma, infection, thrombosis, embolisation or ischaemia of the digits. The purpose of this study was to investigate the correlation between simultaneous arterial blood gas and arterialised earlobe blood samples. MATERIALS AND METHODS This was a descriptive study. Blood sample was collected simultaneously from left radial artery and ear lobe. The ear lobe was arterialised using hot mops for 3 minutes, a bold puncture was made with a lancet and blood was collected in pre-heparinised capillary tubes anaerobically without squeezing the ear lobe. Arterial sample was collected from the left radial artery in preheparinised 2 mL syringes by 22-G needle after modified Allen's test. All samples were collected from the patients after 12 hours of initiation of mechanical ventilation and the samples were analysed using a point-of-care blood gas analyser. RESULTS A total of 82 paired samples were analysed. The baseline demographics were comparable. On Bland-Altman's analysis of pH the mean difference was 0.01, while Limits of Agreement (LOA) were between +0.07 to-0.05 units and all dates were between two standard deviations. On Bland-Altman analysis for PaO2 the mean difference was 18.6 mmHg, while the limits of agreement (LOA) were between 14.2 mmHg to 23.0 mmHg and all the data were with two standard deviations. On Bland-Altman analysis for pCO2 and bicarbonate, we found scattered beyond two standard deviations. Regression analysis was done to find the convection formula for capillary to arterial. PaO2, it was 0.9 (pCO2) + 32.6 mmHg. CONCLUSION Capillary blood gas analysis can be used to estimate the pH and PaO2, but may not be of value for calculating pCO2 or bicarbonate.

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Small Blood-Samples From Ear-Lobe Puncture???a Substitute for Arterial Puncture

Cited by 2 publications

References 0 publications

Blood gas measurement during exercise: a comparative study between arterialized earlobe sampling and direct arterial puncture in adults

Blood gas measurement during exercise: a comparative study between arterialized earlobe sampling and direct arterial puncture in adults

Comparison and Correlation Between Arterial and Capillary Blood Gas Values in Mechanically Ventilated Adults

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