Effects of Mean Arterial Pressure and Needle Size on Arterial Sampler Filling Time

Kl, Johnson; Aj, Johnson; Ka, Barnes; Fh, Douce

doi:10.4187/respcare.00788

Cited by 5 publications

(5 citation statements)

References 5 publications

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“…Some of our results are consistent with those of Johnson et al, 8 who used an extracorporeal laboratory model, and Bender et al, 10 who studied primarily normotensive human subjects. Consistent with our results, both previous studies also showed a significant difference between arterial and venous sampler filling rate.…”

Section: Discussionsupporting

confidence: 92%

“…8 They concluded that there was no significant difference in filling time between 2 different needles, but the study was criticized for lack of clinical validity. 9 Bender et al's study 10 did include human subjects, but only a few subjects with abnormal blood pressure, which the investigators defined as a mean arterial pressure Ͻ 80 mm Hg or Ͼ 100 mm Hg, and the venous filling times were remarkably longer than those in Johnson et al 8 Since there have been no other studies of blood sampling time in subjects with abnormal blood pressure, we studied the effects of abnormal blood pressure on sampler filling time, to determine if filling time can be an accurate indicator of obtaining an arterial rather than a venous sample. Our research questions were: is there a difference between sampler filling time for venous versus arterial blood over the range of abnormal arterial blood pressure?…”

Section: Introductionmentioning

confidence: 99%

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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: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

The Effects of Abnormal Blood Pressure on Arterial Sampler Filling Times

et al. 2013

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“…Our study further supports previous studies conducted by Johnson et al, 1 Bender et al, 2 and Cortes et al, 3 who concluded that arterial sampler filling time can distinguish between arterial and venous punctures. Johnson et al 1 used an extracorporeal laboratory model and tested various needle sizes, whereas Bender et al 2 studied subjects with normal mean arterial pressures, and Cortes et al 3 studied subjects with abnormal blood pressures.…”

Section: Discussionsupporting

confidence: 93%

“…We used an extracorporeal circuit similar to that used by Johnson et al 1 , but our filling rate for the Portex Pro-Vent sampler with a 23-gauge needle at a normal mean arterial pressure was 6.1 Ϯ 0.5 s, almost 10 s less compared with the rate obtained by Johnson et al 1 The reason for this difference may be that Johnson et al 1 collected 2-mL volumes and used more viscous reconstituted human blood, whereas we collected 1 mL of a less viscous synthetic blood. Also contributing to the difference may be our lower blood flow.…”

Section: Discussionmentioning

confidence: 90%

“…These studies used only a single brand of sampler; our study extends their work to all currently available samplers with and without plungers in the United States. Because Johnson et al, 1 Bender et al, 2 and Cortes et al 3 already showed that there is a significant difference between arterial and venous filling times with the Portex Pro-Vent, which is a sampler with a plunger, and because this sampler was included in our study, we chose to compare all samplers with a plunger at only mean arterial pressure. Although we found significant differences in sampler filling rates at a simulated mean arterial pressure between sampler brands, the difference of ϳ1 s should not prevent distinguishing between arterial and venous punctures because the minimum difference between arterial and venous filling rates in all 3 previous studies was reported by Johnson et al 1 as 51.4 s. Currently, clinical practice guidelines suggest that blood color and pulsation may be used to identify arterial samples.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of Sampler Filling Times Among Selected Arterial Blood Samplers

Adu-Yeboah

Kagarise

et al. 2014

Respir Care

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BACKGROUND: True arterial blood samples are essential in making clinical decisions for respiratory patients. Previous studies using only the Portex Pro-Vent arterial sampler have shown a significant difference between arterial and venous filling times. The goal of this study was to determine whether there is a statistically significant difference between sampler filling times measured at a normal mean arterial pressure among multiple arterial samplers with plungers and to determine whether there is a statistically significant difference in filling times between venous and normal mean arterial pressures for a sampler without a plunger. METHODS: We assembled an extracorporeal laboratory model to circulate a synthetic compound composed of 0.9% sodium chloride solution and Life/form artificial blood, and we used hemostats to create pressures within the circuit. We randomly selected samplers and measured the filling times of 4 arterial samplers with plungers at a normal mean arterial pressure (93 ؎ 1 mm Hg). We also measured the filling time of one arterial sampler without a plunger at a normal mean arterial pressure and at a simulated venous pressure (9 ؎ 2 mm Hg). We used the Kruskal-Wallis one-way analysis of variance to compare arterial filling times in samplers, and we used a t test for independent samples to compare venous and arterial filling times in the sampler without a plunger. RESULTS: There was a statistically significant difference between sampler filling times among the 4 arterial samplers with a plunger (P < .001). There was a statistically significant difference between arterial and venous pressure filling times for the sampler without a plunger (P < .001). CONCLUSIONS: Although there was a statistically significant difference between arterial filling times among various samplers with plungers, the difference was < 1 s and was not deemed clinically important. Regardless of the sampler brand being used, respiratory therapists and other clinicians performing arterial punctures can use sampler filling time to identify a successful arterial puncture while drawing blood.

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