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Abstract

Context: There has been very few publications answering why the Arterial Blood Gas (ABG) test being ordered and whether its results affected patient management. Dissemination of guidelines, educational efforts can help in decreasing the unnecessary utilization of ABG thereby reducing the costs and complication Aims: To describe the pattern of Arterial Blood Gas utilization in a tertiary intensive care unit. Settings and Design:This prospective observational study was conducted in the adult ICU consisting of 11 beds. Methods and Material:About 486 ABG tests were performed and analyzed during three months duration. The clinician filled out ABG utilization proforma after test was done. Results:The common reasons for requesting an ABG test were routine (60.28%), following respiratory events (11.72%), and follow up on abnormal reports (9.25%). The clinicians considered PO2, pH, and PCO2 the most important parameters in the ABG test results. Of the results, there was no intervention in 52.2% cases and ventilator settings were changed only in 29.8% of cases. Conclusion:Oftentimes, many ABG tests were ordered as part of a routine investigation. ABG Analysis was done without test results influencing patient management.Keywords: Arterial blood gas; Intensive care unit; Utilization IntroductionThe arterial blood gas (ABG) is a frequently ordered laboratory test. Laboratory tests should be ordered to make accurate diagnoses, change management, monitor the response to management [1,2]. The continued frequency of ABG valuation may be influenced by routine work-patterns and easy access via arterial lines [3]. Many laboratory analysis including ABG are repeated too early [4]. Inappropriate utilization and blood collection not only escalate cost but may also create unnecessary patient discomfort and complications [5]. Ancillary expenditures in the intensive care setting can be decreased without compromising care of the patient [6]. Implementation of practice guidelines for blood gas measurement has been shown to decrease test utilization without affecting outcome [7].We decided to examine ABG test utilization patterns in our Intensive Care Unit (ICU) in an attempt to identify opportunities for improved utilization. We studied why the ABG test being ordered and whether its results affected patient management. Subjects and MethodsThe ethical approval was taken from ethical committee of the hospital. This prospective observational study was conducted in the adult ICU consisting of 11 beds. ABG tests performed outside ICU were not included in this study. The blood gas analyzers are validated to report arterial pH, PCO2, PO2, oxygen saturation, hemoglobin, hematocrit, sodium, potassium, ionized calcium, and whole blood glucose values.The clinician (doctor or nurse) filled out the ABG Survey form after ABG test was done. The utilization survey inquired about the reason for ordering the ABG test, the most important parameters used, and the effect of the results on patient management. The data collection took approximately three...