Venous Blood as an Alternative to Arterial Blood for the Measurement of Carbon Dioxide Tensions

Harrison, Eneida; Gallon, S. C.

doi:10.1093/bja/37.1.13

Cited by 31 publications

(32 citation statements)

References 12 publications

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“…There are numerous studies comparing arterial and venous blood gas values that show a good correlation among arterial, capillary and venous samples in both humans and animals (Harrison and Galloon 1965;Long et al 1971;Harrison et al 1997). However, there are also contradictory reports (Klingstrom et al 1976;Brashear et al 1979).…”

Section: Resultsmentioning

confidence: 99%

Prediction of Arterial Blood Gas Values from Venous Blood Gas Values in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Öğün

Bayır

et al. 2006

Tohoku J. Exp. Med.

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Arterial blood gas (ABG) analysis has an important role in the clinical assessment of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). However, arterial puncture or insertion of an arterial catheter has many drawbacks. The aim of this study was to evaluate whether venous blood gas (VBG) values of pH, partial pressure of carbon dioxide (PCO 2 ) and oxygen (PO 2 ), bicarbonate (HCO 3 ), and oxygen saturation (SO 2 ) can reliably predict ABG levels in patients with AECOPD. One hundred and thirty-two patients with a prior diagnosis of COPD presenting with acute exacerbation according to AECOPD criteria were included in this prospective study. AECOPD is defined as a recent increase in cough, wheezing, the volume and purulence of sputum or shortness of breath necessitating a change in regular medication, including corticosteroids or antibiotics. ABG samples were taken immediately after venous sampling, and both were analyzed. Linear regression analysis was performed and equations were established for the estimation of arterial values. The Pearson correlation coefficients for pH, PCO 2 , HCO 3 , PO 2 , and SO 2 were 0.934, 0.908, 0.927, 0.252, and 0.296, respectively. There was a significant correlation between ABG and VBG values of pH, PCO 2 , and HCO 3 ( p < 0.001). Linear regression equations for the estimation of pH, PCO 2 , and HCO 3 were as follows: arterial pH = 1.004 × venous pH; arterial PCO 2 = 0.873 × venous PCO 2 ; and arterial HCO 3 = 0.951 × venous HCO 3 . VBG analysis can reliably predict the ABG values of pH, PCO 2 and HCO 3 in patients with AECOPD. blood gas; arterial; venous; chronic obstructive pulmonary disease

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Section: Resultsmentioning

confidence: 99%

Prediction of Arterial Blood Gas Values from Venous Blood Gas Values in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Öğün

Bayır

et al. 2006

Tohoku J. Exp. Med.

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“…There are conflicting views concerning the reliability of the PVBG and whether it is sufficiently comparable with the ABG to justify widespread clinical use . One would expect the PVBG to have a lower PO 2 and pH but a greater PCO 2 than the ABG; however, it is not clear whether this relationship is either constant or predictable.…”

Section: Introductionmentioning

confidence: 99%

“…1,2 There are conflicting views concerning the reliability of the PVBG and whether it is sufficiently comparable with the ABG to justify widespread clinical use. [3][4][5] One would expect the PVBG to have a lower PO2 and pH but a greater PCO2 than the ABG; however, it is not clear whether this relationship is either constant or predictable. It is also plausible that disease states affecting venous and arterial flow would result in a greater disparity between the measured variables in the PVBG and ABG.…”

Section: Introductionmentioning

confidence: 99%

Peripheral venous and arterial blood gas analysis in adults: are they comparable? A systematic review and meta‐analysis

et al. 2014

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Peripheral venous blood gas (PVBG) analysis is increasingly being used as a substitute for arterial blood sampling; however, comparability has not been clearly established. To determine if the pH, PCO2 and PO2 obtained from PVBG analysis is comparable with arterial blood gas (ABG) analysis. A search was conducted of electronic databases as well as handsearching of journals and reference lists through December 2012 to identify studies comparing PVBG with ABG analysis in adult subjects. A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. A meta-analysis using a random effects model was used to calculate the average difference (bias) and the limits of agreement for the venous and arterial pH, PCO2 and PO2. A total of 18 studies comprising 1768 subjects were included in the meta-analysis. There was considerable heterogeneity between studies with I 2 approaching 100%. There was little difference between the pH obtained from the PVBG and the ABG, with the arterial pH typically 0.03 higher than the venous pH (95% confidence interval 0.029-0.038). The venous and arterial PCO2 were not comparable because the 95% prediction interval of the bias for venous PCO2 was unacceptably wide, extending from −10.7 mm Hg to +2.4 mm Hg. The PO2 values compared poorly, the arterial PO2 typically 36.9 mm Hg greater than the venous with significant variability (95% confidence interval from 27.2 to 46.6 mm Hg). PVBG analysis compares well with ABG analysis for pH estimations in adults but not to the PCO2 or PO2. These differences are sufficiently large to be of clinical significance.

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“…Since both maternal respiratory and metabolic changes are reflected in the foetus (15) it is obvious that simultaneous determination of the maternal acidbase status is necessary to obtain an adequate interpretation of the foetal values. Different sources have been used for collection of maternal blood for acid-base studies, such as vein (1,5,9), arterialized capillary (9, lo), arterialized vein (41, and artery (12,14,20).…”

Section: Cord Bloodmentioning

confidence: 99%

Low Dose Intermittent Epidural Anaesthesia with Lidocaine for Vaginal Delivery II

Zador

Nilsson

1974

Acta Obstet Gynecol Scand

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A bsfruci. Intermittent lumbar epidural block, using lidocaine without (series I), or with epinephrine (series II), for pain relief in.labour was carried out in a total of 190 women with uncomplicated pregnancies. In a number of randomly selected cases in these two series the uterine contractility, the foetal heart rate pattern, and the acid-base balance of the mothers and their foetuses were studied. Transitory decrease in uterine activity, primarily due to depressed intensity of the contractions, was observed after each injection in both series. This phenomenon was, however, much more pronounced in cases where epinephrine was added to the local anaesthetic solution. In both series the effect on the contractions declined with the number of injections. Ominous foetal heart rate patterns were rare and occurred almost exclusively in association with transient maternal hypotension. Good correlation was found between maternal arterial, and arterialized capillary blood with respect to the acid-base components. The acid-base values in foetal scalp blood, maternal capillary blood, and in umbilical cord blood showed a less pronounced tendency to metabolic acidosis in cases where epidural blocks were given than in cases in a non-anaesthetized control group. Prolongation of the second stage was accompanied by the development of metabolic acidosis in anaesthetized, as well as in nonanaesthetized cases. In the epidural series, however, this acidosis tended to appear later and to develop more slowly, indicating an overall good and stable intrauterine foetal condition. In a previous publication by the authors (24) a low dose regimen for lumbar epidural anaesthesia during labour and delivery was evaluated regarding analgetic effect, maternal and foetal blood levels of lidocaine with special reference to the risk of accumulation of the local anaesthetic agent. It was concluded that adequate analgesia could be obtained with hourly injections of 10 ml of 0.5 per cent lidocaine with epinephrine 1:200,000 during the first stage of labour, and with 10 ml doses of 1 per cent lidocaine with epinephrine 1 :200,000 hourly during the second stage. The maternal, foetal and cord blood levels of lidocaine were low, and the risk of accumulation of the drug to the proximity of assumed toxic levels was found to be minimal. When the same lidocaine dose schedule without added epinephrine was tried, the analgesia was often inadequate, maternal and neonatal blood lidocaine levels higher, and the risk of accumulation more evident. It was observed that the mean duration of labour among primiparous women was significantly longer in cases receiving epidural blocks than in a randomly selected group of control patients who had not received regional anaesthesia.Changes in foetal heart rate patterns, decrease in foetal pH, and metabolic acidosis in the neonatal period have been described in connection with lumbar epidural anaesthesia (6,13,19,26). A reduction of the normal beat to beat variations in foetal heart rate recordings which is sometimes observed ...

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Venous Blood as an Alternative to Arterial Blood for the Measurement of Carbon Dioxide Tensions

Cited by 31 publications

References 12 publications

Prediction of Arterial Blood Gas Values from Venous Blood Gas Values in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Prediction of Arterial Blood Gas Values from Venous Blood Gas Values in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Peripheral venous and arterial blood gas analysis in adults: are they comparable? A systematic review and meta‐analysis

Low Dose Intermittent Epidural Anaesthesia with Lidocaine for Vaginal Delivery II

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