Venous vs arterial blood gases in the assessment of patients presenting with an exacerbation of chronic obstructive pulmonary disease

McCanny, Peter; Bennett, Kathleen; Staunton, Paul; McMahon, Geraldine

doi:10.1016/j.ajem.2011.06.011

Cited by 53 publications

(49 citation statements)

References 10 publications

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“…2 During a COPD exacerbation, when P aCO 2 is higher than normal, there is insufficient agreement between venous and arterial P CO 2 for a venous blood measurement to replace an arterial blood measurement in determining the degree of hypercarbia. 3 Therefore, it is crucial to be certain of obtaining an arterial sample, not a venous sample. Clinical practice guidelines recommend assessing the color and pulsatile flow of the blood during sampling.…”

Section: Introductionmentioning

confidence: 99%

The Effects of Abnormal Blood Pressure on Arterial Sampler Filling Times

et al. 2013

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BACKGROUND: Sampler filling time begins with the initial flash of blood in the needle hub until the preset sampler volume is obtained. Previous studies have shown statistically significant differences between arterial and venous sampler filling times, but included only a few subjects with abnormal blood pressures. OBJECTIVE: To determine whether the time required to fill a vented arterial sampler is an accurate indication of a successful arterial blood sample in adults with abnormal blood pressure. We hypothesized that mean arterial pressure and arterial sampler filling time would have a negative correlation, and that venous sampler filling time would be significantly longer than arterial filling time. METHODS: We studied 40 subjects: 25 arterial subjects, and 15 venous subjects. The arterial subjects included 3 groups: hypertensive, hypotensive, or normal. During the arterial and venipuncture procedures, we measured sampler filling time and recorded blood volume. The P O 2 of the samples was measured. Additionally, blood pressure and S pO 2 were measured in the arterial group. RESULTS: The mean sampler filling time was 220.4 s/mL for the venous group, and 18.1 s/mL for all 3 arterial groups combined. There were significant differences between each mean arterial sampler filling rate and mean venous filling rate (P < .001). There were no significant differences in mean sampler filling rate between the arterial subgroups (P > .99). The correlation between mean arterial pressure and filling rates was 0.06 (P ‫؍‬ .38). CONCLUSIONS: There is a significant difference between arterial and venous filling rates. There was no relationship between filling time and abnormal mean arterial pressure. Regardless of the arterial pressure, the arterial sampler filling time can be used as an indicator of a successful arterial puncture at the bedside.

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Section: Introductionmentioning

confidence: 99%

The Effects of Abnormal Blood Pressure on Arterial Sampler Filling Times

et al. 2013

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“…Besides, such sophisticated device demands careful handling and adequate maintenance raising the cast of analysis. An ample evidence is available on agreement in ABG and VBG values but it does not reduce the cast load over a patient 3451516. So, this study was intended to focus on the unseen burdens over patient as well as the health care institutes and to look for a relatively easy, price-worthy and more specific measures.…”

Section: Discussionmentioning

confidence: 99%

“…Although various studies suggest that a venous sample is relatively accurate for acid–base assessment,3456 VBG analysis has not gained much acceptance as a substitute for ABG analysis. On the contrary, Bicarbonate ions make up ~ 95% of the total carbon dioxide of the plasma, and hence both of them have been used interchangeably.…”

Section: Introductionmentioning

confidence: 99%

Comparison of values of traditionally measured venous bicarbonate with calculated arterial bicarbonate in intensive care unit patients of a hospital in a third-world country

et al. 2014

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Background:Measurement of serum or plasma bicarbonate (HCO3−) from a sample of peripheral venous blood is routinely practiced in hospital patient managements. HCO3− status can also be obtained by a simple calculation during blood gas analysis requiring arterial blood as sample which is cumbersome for both patient and doctor. This study compared the measured bicarbonate levels with calculated arterial values in intensive care unit (ICU) patients to determine whether traditionally measured venous HCO3− and calculated HCO3− values [from arterial blood gas (ABG) analyzers] can be used interchangeably.Materials and Methods:This prospective study was carried out at a tertiary care teaching hospital in Dhaka, the capital of Bangladesh. A total of 56 adult patients with diverse medical conditions, presenting at the ICU of the health centre were enrolled in this study when deemed by the treating physician to have an ABG analysis. Arterial and venous samples were taken as close in time as possible for gas analysis and routine blood tests.Results:The HCO3− levels from ABG and traditionally measured serum showed acceptably narrow 95% limits of agreement using the Bland-Altman method.Conclusions:More widely prescribed venous HCO3− measurements can also be a useful substitute for an expensive ABG analyzer in resource-constrained health care sectors when required. However, accuracy of venous blood in assessment of additional ABG parameters is yet to be discovered.

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“…A study in 2012 showed venous pH and HCO 3 values had an excellent correlation with the values of arterial samples (11). On the other hand, a systematic review in 2014 showed that the peripheral venous and arterial PCO 2 were not comparable (12).…”

Section: Introductionmentioning

confidence: 99%

The Relationship between Arterial and Central Venous Blood Gases Values in Patients Undergoing Mechanical Ventilation after Cardiac Surgery

et al. 2018

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BackgroundThe most straightforward method of ascertaining arterial PO2, PCO2, and other components of blood gas is to measure them directly from a blood sample. In situations in which arterial puncture cannot be achieved or may be technically difficult, the venous blood sample can be used.MethodsIn a prospective analytical study, 80 patients undergoing mechanical ventilation after open-heart surgery in the intensive care unit were evaluated. Simultaneous, matched arterial and central venous blood gas samples were taken from radial artery line and central vein, respectively, when the ABG (arterial blood gases) assessment was needed. Arterial and central venous blood samples were analyzed and data were expressed as mean and ± SD.ResultsThe Pearson correlation coefficient for pH, PCO2, HCO3, and SatO2 was 0.898, 0.940, 0.840, and 0.567, respectively. There was a significant correlation between arterial and central venous values of pH, PCO2, and HCO3 (P < 0.0001). The mean difference between arterial and central venous PCO2 was -2.44 ± 2.6 mmHg, and the mean venous pH value was only 0.021 ± 0.037 units lower than the mean arterial value. In addition, the calculated mean bicarbonate concentration in venous blood was only about 0.06 ± 1.5 mEq.L higher than the mean arterial value.ConclusionsThe central venous PCO2, pH, and HCO3 measured during mechanical ventilation in the intensive care unit approximate arterial values closely enough to permit the estimation of the adequacy of ventilation and acid-base status. The central venous Sat O2 does not reliably parallel the arterial Sat O2. In conclusion, venous blood sampling can potentially reduce the requirement for ABG sampling in special situations.

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Venous vs arterial blood gases in the assessment of patients presenting with an exacerbation of chronic obstructive pulmonary disease

Cited by 53 publications

References 10 publications

The Effects of Abnormal Blood Pressure on Arterial Sampler Filling Times

The Effects of Abnormal Blood Pressure on Arterial Sampler Filling Times

Comparison of values of traditionally measured venous bicarbonate with calculated arterial bicarbonate in intensive care unit patients of a hospital in a third-world country

The Relationship between Arterial and Central Venous Blood Gases Values in Patients Undergoing Mechanical Ventilation after Cardiac Surgery

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