Can venous blood gas be used instead of arterial blood gas in emergency department?

Abstract

Objective: In our study, we aimed to evaluate the usability of venous blood gas (VBG) in substitution for arterial blood gas (ABG). Methods: In this study, 110 patients with respiratory complaints, who were brought intubated were evaluated prospectively. Arterial and venous blood gases were taken simultaneously shortly before the initiation of oxygen therapy in the emergency department. PH, pO2, pCO2, SaO2, HCO3, lactate (Lac) and BEecf values were recorded. Results: Of the 110 patients included in the study, 75 were male (68.2%), 35 were female (31.8%), and they had a mean age of 53.7 ± 23.1 years. A strong positive correlation between PH, PCO2, HCO3-, BEecf, Lac values (p=0.001) and positive correlation between PO2 and SaO2 values (p= 0.002) were detected. Conclusion: We can conclude that venous blood gas be used in substitution for arterial blood gas in patients who are presented to emergency service and it may reduce the need for arterial blood gas sampling.

Keywords

• Arterial Blood Gas
• Venous Blood Gas
• Emergency Department

References

1. Üstün E. Editör. Şahinoğlu H. Asid-Baz dengesi ve kan gazları analizi : Yoğun bakım sorunları ve tedavileri. 1992;43-4.
2. Özen N. Cerrahi hastalarda asit-baz dengesi bozuklukları ve tedavisi. Genel Cerrahi 1996; 29-32.
3. Kelly AM, Mc Alpine R, Kyle E. Venous pH can safely replace arterial pH in the initial exaluation of patients in the emergency departmant Emerg Med J 2000; 18(5): 340-2. https://doi.org/ 10.1136/emj.18.5.340.
4. Zahn RL, Weil MH. Central venous blood for monitoring pH and PCO2 in the critically ill patients. J Thorac Cardiovasc Surg 1966;105-11.
5. Moore EE, Good JT. Mixed venous and arterial pH: A comparison during hemorrhagic shock and hypothermia. Ann Emerg Med 1982; 11: 300-2. https://doi.org/10.1016/s0196-0644(82)80127-3.
6. Bradenburg MA, Dire DJ. Comparison of arterial and venous blood gas volues in the emergency department evaluation of patients with diabetic ketoasidosis. Ann Emerg Med 1998;31(4): 459-65. https://doi.org/10.1016/s0196-0644(98)70254-9
7. Hale PJ, Nattrass M. A comparison of arterial and non-arterialized capillary blood gases in diabetic ket oacidosis. Diabet Med 1988; 5(1): 176-80. https://doi.org/10.1111/j.1464-5491.1988.tb00946.x
8. Zetos AA, Kainis EG, Zetou VNL, Tzitzic S,Boufas A. Correlation between arterial and venous pH of patients in the emergency department of a chest diseases hospital. P (2827) Eur Respir J 2003; 22 (45): 444.

9. Forster HV, Dempsey JA, Thomson J, Vidruk E.Do Pico GA. Estimation of arterial PO2, PCO 2,pH and lactate from arterialised venous blood J App Phys 1972; 32: 134-7.
10. Harrison AM. Comparison of simultaneously obtained arterial and capillary blood gases in pediatric intensive care unit patients. Crit Care Med 1997; 25: 1904-1908. https://doi.org/10.1097/00003246-199711000-00032
11. Kelly AM, Kyle E, McAlpine R. Venous PCO2 and pH can be used to screen for significant hypercarbia in emergency patients with acute respiratory disease. The Journal of Emergency Medicine 2002; 22(1): 15-9. https://doi.org/10.1016/s0736-4679(01)00431-0
12. Kelly AM, Mc Alpine R, Kyle E. Agreement between bicarbonate measured on arterial and venous blood gases. Emerg Med Australas 2004; 16(5-6): 407-9. https://doi.org/10.1111/j.1742-6723.2004.00642.x.
13. Chu YC, Chen CZ, Lee CW, Chen CW, Chang HY, Hsiue TR. Prediction of arterial blood gas values from venous blood gas values in patients with acute respiratory failure receiving mechanical ventilation. J Formos Med Assoc 2003; 102(8): 539 -43.
14. Yildizdas D, Yapicioglu H, Yilmaz HL, Sertdemir Y. Correlation of simultaneously obtained capillary, venous and arterial blood gases of patients in a paediatric intensive care unit. Arch Dis Child 2004; 89(2): 176-80. https://doi.org/10.1136/adc.2002.016261
15. Lim BL, Kelly A-M. A meta-analysis on the utility of peripheral venous blood gas analyses in exacerbations of chronic obstructive pulmonary disease in the emergency department. J Eur Soc Emerg Med 2010; 17: 246–8.
16. Koul PA, Khan UH, Wani AA, Eachkoti R, Jan RA, Shah S, et al. Comparison and agreement between venous and arterial gas analysis in cardiopulmonary patients in Kashmir valley of the Indian subcontinent. Ann Thorac Med 2011; 6:33–7. https://doi.org/10.4103/1817-1737.74274
17. Dantzker DR. The influence of cardiovascular function on gas exchange. Clin Chest Med. 1983;4(2):149-59.