Peripheral venous blood gas analysis: An alternative to arterial blood gas analysis for initial assessment and resuscitation in emergency and intensive care unit patients

Abstract

Arterial blood gas (ABG) analysis is the gold standard method for assessment of oxygenation and acid base analysis, yielding valuable information about a variety of disease process. This study is aimed to determine the extent of correlation between arterial and peripheral venous samples for blood gases and acid base status in critically ill and emergency department patients and to evaluate if venous sample may be a better alternative for initial assessment and resuscitation. The prospective study was conducted on 45 patients of either sex in the age group of 15-80 years of intensive care unit and emergency ward. Relevant history, presenting complaints, vital signs, and indication for testing were recorded. Arterial and peripheral venous samples were drawn simultaneously in a pre-heparinized syringe and analyzed immediately for blood gases and acid base status. Mean difference and Pearson's product moment correlation coefficient was used to compare the result. After statistical evaluation, the present study shows minimal mean difference and good correlation (r > 0.9) between arterial and peripheral venous sample for blood gases and acid base status. Correlation in PO2 measurement was poor (r < 0.3). Thus, venous blood may be a useful alternative to arterial blood during blood gas analysis obviating the need for arterial puncture in difficult clinical situation especially trauma patients, for initial emergency department assessment and early stages of resuscitation.

Agreement of Arterial Sodium and Arterial Potassium Levels with Venous Sodium and Venous Potassium in Patients Admitted to Intensive Care Unit

“…Herrington WG et al, observed that potassium values of arterial samples were in agreement with the potassium values measured in serum [14]. Shilpi Awasthi, et al, observed that there was a strong correlation between the arterial sodium and potassium and venous sodium and potassium which were similar to the findings of the present study [15].…”

Central Venous Blood Gas Analysis: An Alternative to Arterial Blood Gas Analysis for pH, PCO2, Bicarbonate, Sodium, Potassium and Chloride in the Intensive Care Unit Patients

“…1A). This is consistent with the findings of studies by Tregger et al, 3 Awasthi et al, 4 Middleton et al, 9 and Bo Ra kim et al, 10 which have shown a mean A-V difference for pH ranging from –0.04 to 0.053.…”

“…Earlier studies have shown good correlation between ABG and VBG values with respect to pH, PCO 2 , and bicarbonate in adult patients presented to the emergency department and ICU. 3,4 Studies involving ICU patients have shown good correlation for potassium measured between ABG machine and point of care analyzers. 5,6 However, there is limited information regarding relationship between the venous and arterial values for pH, PCO 2 , bicarbonate, and electrolytes in critically ill patients.…”

Peripheral venous blood gas analysis: An alternative to arterial blood gas analysis for resuscitation and monitoring of critically ill patients.

“…Awasthiet al, 8 conducted a prospective study to determine whether peripheral venous blood gas analysis can be an alternative to arterial blood gas analysis for initial assessment and resuscitation in emergency and intensive care unit patients. The study showed minimal mean difference and good correlation (r> 0.9) between arterial and peripheral venous sample for blood gases and acid base status but correlation in PO 2 measurement was poor (r< 0.3).…”