Comparison of arterial and venous blood gases in cases with obesity hypoventilation syndrome and neuromuscular disease

Orucova, Hicran; Çağatay, Tülin; Çağatay, Penbe; Bingöl, Züleyha; Okumuş, Gülfer; Kıyan, Esen

doi:10.1183/13993003.congress-2018.pa810

Cited by 2 publications

(3 citation statements)

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“…12,14,15 These findings have been replicated in multiple prospective studies comparing peripheral venous and arterial Pco 2 . 4,8,[18][19][20][21] Central VBG measurement may thus be a reasonable alternative to ABG monitoring in several clinical circumstances.…”

Section: Studies Comparing Central Vbg and Abg In Critically Ill Pati...mentioning

confidence: 99%

Comparing Central Venous Blood Gas to Arterial Blood Gas and Determining Its Utility in Critically Ill Patients: Narrative Review

Chong

Saha

Medarov

2021

Anesthesia &Amp; Analgesia

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Arterial blood gas (ABG) analysis is used in critical care units to determine the degree of oxygenation, adequacy of ventilation, and the presence and severity of acid-base disturbances in the body. However, arterial puncture may result in complications, and the difficulty in acquiring arterial blood may delay care. Central venous blood gas (VBG) is a potentially more accessible alternative to ABG sampling. Current evidence suggests that pH and Pco 2 obtained via peripheral VBG correlate well with ABG measurement. Nevertheless, the value of using central VBG to guide clinical decisions or as a surrogate for ABG is unclear. The purpose of this review is to explore the relationship between ABGs and central VBGs in critically ill patients. We performed a MEDLINE search using the following search terms: venous blood gas, arterial blood gas, and central venous blood gas. We excluded studies that did not involve human subjects, and only pH and Pco 2 values were reviewed and examined from the studies included. All cited references from included studies were also reviewed to identify relevant literature. We identified 7 studies that met our criteria. In studies of hemodynamically stable patients, the mean difference between arterial and central venous pH and Pco 2 was 0.03 units and 4–6.5 mm Hg, respectively. However, in patients with circulatory failure, the difference between central venous and arterial pH/Pco 2 was 4-fold greater. We concluded that central VBG parameters of pH and Pco 2 are potentially good surrogates for determining arterial pH and Pco 2 in a stable patient without severe acid-base disturbances. Furthermore, central VBG can be used as a useful screening tool for arterial hypercapnia. In addition, we derived an adjustment formula for ABG conversion from central VBG: (1) arterial pH = venous pH + 0.05 units and (2) arterial Pco 2 = venous Pco 2 − 5 mm Hg.

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Section: Studies Comparing Central Vbg and Abg In Critically Ill Pati...mentioning

confidence: 99%

Comparing Central Venous Blood Gas to Arterial Blood Gas and Determining Its Utility in Critically Ill Patients: Narrative Review

Chong

Saha

Medarov

2021

Anesthesia &Amp; Analgesia

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“…First, we assessed VBGs rather than arterial blood gases (ABGs), in order to reduce discomfort from arterial sampling. While VBGs are not as accurate, they correlate closely with ABGs in stable patients with OHS 38 . Second, only some participants met full OHS criteria, since we used bicarbonate to screen for possible OHS 39 .…”

Section: Discussionmentioning

confidence: 99%

“…While VBGs are not as accurate, they correlate closely with ABGs in stable patients with OHS. 38 Second, only some participants met full OHS criteria, since we used bicarbonate to screen for possible OHS. 39 The European Respiratory Society Task Force classifies patients with HCO 3 À ≥ 27 mmol/L without daytime hypercapnia as having stage 2 OHS 40 since HCO 3…”

Section: Discussionmentioning

confidence: 99%

Ketogenic diet acutely improves gas exchange and sleep apnoea in obesity hypoventilation syndrome: A non‐randomized crossover study

Osman

Kim

et al. 2023

Respirology

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Background and Objective Obesity hypoventilation syndrome (OHS) causes hypercapnia which is often refractory to current therapies. We examine whether hypercapnia in OHS can be improved by a ketogenic dietary intervention. Methods We conducted a single‐arm crossover clinical trial to examine the impact of a ketogenic diet on CO2 levels in patients with OHS. Patients were instructed to adhere to 1 week of regular diet, 2 weeks of ketogenic diet, followed by 1 week of regular diet in an ambulatory setting. Adherence was assessed with capillary ketone levels and continuous glucose monitors. At weekly visits, we measured blood gases, calorimetry, body composition, metabolic profiles, and sleep studies. Outcomes were assessed with linear mixed models. Results A total of 20 subjects completed the study. Blood ketones increased from 0.14 ± 0.08 during regular diet to 1.99 ± 1.11 mmol/L (p < 0.001) after 2 weeks of ketogenic diet. Ketogenic diet decreased venous CO2 by 3.0 mm Hg (p = 0.008), bicarbonate by 1.8 mmol/L (p = 0.001), and weight by 3.4 kg (p < 0.001). Sleep apnoea severity and nocturnal oxygen levels significantly improved. Ketogenic diet lowered respiratory quotient, fat mass, body water, glucose, insulin, triglycerides, leptin, and insulin‐like growth factor 1. Rebound hypercapnia was observed after resuming regular diet. CO2 lowering was dependent on baseline hypercapnia, and associated with circulating ketone levels and respiratory quotient. The ketogenic diet was well tolerated. Conclusion This study demonstrates for the first time that a ketogenic diet may be useful for control of hypercapnia and sleep apnoea in patients with obesity hypoventilation syndrome.

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Comparison of arterial and venous blood gases in cases with obesity hypoventilation syndrome and neuromuscular disease

Cited by 2 publications

References 0 publications

Comparing Central Venous Blood Gas to Arterial Blood Gas and Determining Its Utility in Critically Ill Patients: Narrative Review

Comparing Central Venous Blood Gas to Arterial Blood Gas and Determining Its Utility in Critically Ill Patients: Narrative Review

Ketogenic diet acutely improves gas exchange and sleep apnoea in obesity hypoventilation syndrome: A non‐randomized crossover study

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