AKUT SOLUNUM YETMEZLİĞİ OLAN KOAH'LI OLGULARDA ARTERYEL VE VENÖZ KAN GAZI ÖRNEKLERİNİN KARŞILAŞTIRILMASI

Yıl 2005, Cilt: 19 Sayı: 1, 7 - 13, 01.05.2005

Hatice Dilber Gülru Polat Melih Büyükşirin Serpil Karadağ Polat Gültekin Tibet

Öz

Arter kan gazı analizi solunum yetmezlikli olgularda pH ve Pco2 değerlerini görmek için standart bir yöntemdir. Ancak arter kanının alınması ağrılı ve vasküler komplikasyonu olan bir yöntem olup sağlık personeline de bulaşıcı enfeksiyonlar yönünden risk getirir. Bu çalışmada, akut solunum yetmezlikli KOAH'lı olgularda pH, pCO2, HCO3 değerleri açısından venöz kan örneklerinin arteriyel kan örnekleri yerine güvenle kullanılıp kullanılmayacağı araştırıldı. ‚alışmaya KOAH tanısı olup akut solunum yetmezliği nedeniyle kliniğimize yatırılan 100 olgu alındı. Olgulardan oda havasında eş zamanlı arteriyel ve venöz kan örnekleri alındı ve analiz edildi. pH, pCO2, HCO3 değerleri açısından arteriyel ve venöz kan örnekleri karşılaştırıldığında aralarında kuvvetli ilişki saptandı

Anahtar Kelimeler

Arter kan gazı analizi, KOAH

COMPARISON OF VENOUS AND ARTERIAL BLOOD VALUES IN CASES OF COPD WITH ACUTE RESPIRATORY FAILURE

Öz

Arterial blood gas analysis is a standard method
for the evaluation of pH and pCO 2 values in the
cases of acute respiratory failure. But punction
of arterial blood is painful, had vascular
complications and brings risks for infectious
diseases. In this study, we aimed to investigate
whether venous blood samples can replace the
arterial ones for pH, pCO2 and HCO 3 values in
cases of COPD with acute respiratory failure.
One hundred cases with the diagnosis of COPD
who had been interned because of acute
respiratory failure included in this study. Arterial
and venous blood samples taken at the room air
and analysed. There was significant relation
between arterial and venous blood samples for
the values of pH, pCO2 and HCO3 (r values;
0.778, 0.728, 0.823 respectively, p<0.0001).
Formulas made for the calculation of arterial
blood values from venous values with lineer
regression analysis. In conclusion; venous blood
values can replace arterial blood ones in cases
of COPD with acute respiratory failure when
frequent blood gas analysis necessary, patient
had infectious disease or does not have arterial
cannula.

Anahtar Kelimeler

Arterial blood gas analysis, COPD

Kaynakça

• Celli BR, Mac Nee W, ATS / ERS. Standards for the diagnosis and treatment of patients with COPD a summary of the ATS/ ERS position paper. European Respiratory Journal 2004; 23 (6): 932-46.
• Global Initiative for chronic Obstructive Lung Disease. National Institutes of Health. National Hearth, Lung and Blod Institute 2003 Rehberi.
• Gömez PF, Rodriguez-Roisin R. Kronik Obs- trüktif akciğer hastalığında küresel giriflim (GOLD) Rehberi Current opinion in Pulmonary Medicine 2002; 8(2): 81-6.
• Atasever A. KOAH erken tanısı. Galenos Dergisi Ocak 2004: 31-34.
• Erk M. KOAH alevlenmesi. Solunum Dergisi 2003; 5(6): 285-9.
• Yıldırım N. Kan gazlarının değerlendirilmesi. Göğüs Hastalıkları Kitabı. Ankara 2000 (5): 65-73.
• 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
• Kelly AM, Mc Alpine R, Kyle E. Venous pH can safely replace arterial pH in the initial exa- luation of patients in the emergency depart- mant Emerg Med J 2000; 18(5): 340-2.
• Gambino SR. Comparisons of pH in human arterial, venous and capillary blood. Am J Clin Pathol 1959; 32: 298-300.
• Gambino SR. Normal values for adult human venous plasma pH and CO2 content. Am J Clin Pathol 1959; 32: 294-7.
• Zahn RL, Weil MH. Central venous blood for monitoring pH and PCO2 in the critically ill patients. J Thorac Cardiovasc Surg 1966; 105-11.
• Moore EE, Good JT. Mixed venous and arterial pH: A comparison during hemorrhagic shock and hypothermia. Ann Emerg Med 1982; 11: 300-2.
• 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.
• Bradenburg MA, Dire DJ. Comparison of arterial and venous blood gas volues in the emer- gency department evaluation of patients with diabetic ketoasidosis. Ann Emerg Med 1998; 31(4): 459-65.
• Gokel Y, Paydas S, Koseoğlu Z, Alparslan N, Seydaoğlu G. Comparison of Blood Gas and Acid- Base measurements in arterial and venous blood samples in patients with üremic asidosis and diabetic ketoacidosis in the emergency room. Am J Nephrol 2000; 20: 319-23.
• 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.
• Kirubakaran C, Gnananayagam JE. Sundaravalli EK. Comparison of blood gas values in arte- rial and venous blood. Indian J Pediatr 2003; 70 (10): 781-5.
• Ma OJ, Rush MD, Godfrey MM, Gaddis G. Arterial blood gas results rarely influence emergency physicians management of patients with suspected diabetic ketoacidosis. Acad Emerg Med 2003; 10(8): 836-41.
• Yıldızdas D, Yapıcıoğlu H, Yılmaz 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.
• Forster HV, Dempsey JA, Thomson J, Vidruk E. Do Pico GA. Estimation of arterial PO2, PCO2, pH and lactate from arterialised venous blood J App Phys 1972; 32: 134-7.
• Rang LCF, Murray HE, Mac Gougan K, Pickett W. Comparison of arterial and venous blood gases in 218 emergency department patients. Acad Emerg Med 2000; 7: 434-5.
• Harrison AM. Comparison of simultaneously obtained arterial and capillary blood gases in pediatric intensive care unit patients. Crit Care Med 1997; 25: 1904-1908 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.
• 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. Yazıflma Adresi: Dr. Gülru POLAT
• Dr. Suat Seren Göğüs Hastalıkları ve Cerrahisi
• Eğitim ve Arafltırma Hastanesi Yeniflehir/İZMİR
• Tel : [phone]
• Faks: 0232 458 72 62
• E-mail: [e-mail]