Santos-Martínez LE, Ixta-Quintana DA, Quevedo-Paredes J, Rodríguez-Almendros NA, Treviño-Mejía AJ, Soto-Márquez P

Language: Spanish
References: 22
Page: 342-346
PDF size: 789.35 Kb.

ABSTRACT

Background: Peripheral venous blood gases may be useful in subjects with exacerbation of chronic obstructive pulmonary disease to evaluate their gas exchange.
Objective: To describe the variability of parameters of arterial and peripheral venous blood gases in subjects with stable obstructive pulmonary disease.
Methods: Cross-sectional design, consecutive subjects were studied in a blinded manner, while arterial and peripheral venous blood was obtained for analysis. Variability was established with Bland-Altman statistical method and its magnitude with the intraclass correlation coefficient (95 % confidence interval).
Results: Three hundred blood samples from 150 patients were studied, 89 (59.3%) women, age 66 ± 10 years old, body mass index 28.44 ± 4.81 Kg/m2. Mean difference (bias) [intraclass correlation coeficient] pH 0.012 (-0.009, 0.032) [0.927], Carbon dioxide pressure - 6.5 (-14.1, 1.1) [ 0.643], serum bicarbonate -1.3 (-3.3, 0.7) [0.929], base excess -1 (-4, 2.1) [0.904], hemoglobin -0.1 (-1.9, 1.8) [0.947].
Conclusions: The variability of pH, serum bicarbonate, and hemoglobin are similar in both blood samples. These arterial or peripheral venous blood gas parameters could be used interchangeably.

REFERENCES

1. Rennard IS, Bradley D. Early chronic pulmonary disease: definitions, assessment and prevention. Lancet. 2015;385:1778-88.

2. O´Donnell DE, Laveneziana P, Webb K, Neder JA. Chronic Obstructive pulmonary disease. Clinical integrative physiology. Clin Chest Med. 2014;35:51-69.

3. Jeong SH, Lee H, Carriere KC, Shin SH, Moon SM, Jeong BH, et al. Comorbidity as a contributor to frequent severe acute exacerbation in COPD patients. Int J Chron Obstruct Pulmon Dis. 2016:11:1857-65.

4. Mortensen JD. Clinical sequelae from arterial needle puncture, cannulation, and incision. Circulation. 1967;35:1118-23.

5. Santos-Martínez LE, Martínez-Guerra ML, Duran A, Rodríguez F, Gotés J, Roquet I, et al. Capillary blood gas test usefulness to evaluate gas exchange with 21% and 100% of oxygen inspired fractions in subjects with stable cardiopulmonary disease at 2,240 meters above sea level. Arch Cardiol Mex. 2009;79(1):18-26.

6. Kelly AM. Can peripheral venous blood gases replace arterial blood gases in emergency medical care. Emerg Med Australas. 2010;22:493-8.

7. 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. J Emerg Med. 2002;22(1):15-9.

8. Kelly AM, Kerr D, Middleton P. Validation of venous pCO2 to screen for arterial hypercarbia in patients with chronic obstructive airways disease. J Emerg Med. 2005;28(4):377-9.

9. Ak A, Ogun CO, Bayir A, Kayis SA, Koylu R. Prediction of arterial blood gas values from venous blood gas values in patients with acute exacerbation of chronic obstructive pulmonary disease. Tohoku J Exp Med. 2006;210(4):285- 90.

10. Razi E, Moosavi GA. Comparison of arterial and venous blood gases analysis in patients with exacerbation of chronic obstructive pulmonary disease. Saudi Med J. 2007;28(6):862-5.

11. McCanny P, Bennett K, Staunton P, McMahon G. Venous vs arterial blood gases in the assessment of patients presenting with an exacerbation of chronic obstructive pulmonary disease. Am J Emerg Med. 2012;30(6):896- 900.

12. McKeever TM, Hearson G, Housley G, Reynolds C, Kinnear W, Harrison TW, et al. Using venous blood gas analysis in the assessment of COPD exacerbations: a prospective cohort study. Thorax. 2016;71(3):210-5.

13. Lim BL, Kelly AM. A meta-analysis on the utility of 2 peripheral venous blood gas analyses in exacerbations of chronic obstructive pulmonary disease in the emergency department. Eur J Emerg Med. 2010;17(5):246-8.

14. Celli BR, Decramer M, Wedzicha JA, Wilson KC, Agustí A, Criner GJ, et al. An Official American Thoracic Society/European Respiratory Society Statement: Research questions in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2015;191(7):e4-e27.

15. Allen EV. Thromboangitis obliterans: Methods of diagnosis of chronic occlusive arterial lesions distal to the wrist with illustrative cases. Am J Med Sci. 1929;178:237-44.

16. Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986;1:307-10.

17. Brandenburg MA, Dire DJ. Comparison of arterial and venous blood gas values in the initial emergency department evaluation of patients with diabetic ketoacidosis. Ann Emerg Med. 1998;31(4):459-65.

18. Malatesha G, Singh NK, Bharija A, Rehani B, Goel A. Comparison of arterial and venous pH, bicarbonate, PCO2 and PO2 in initial emergency department assessment. Emerg Med J. 2007;24(8):569-71.

19. Masip J, De Mendoza D, Planas K, Paez J, Sanchez B, Cancio B. Peripheral venous blood gases and pulseoximetry in acute cardiogenic pulmonary oedema. Eur Heart J Acute Cardiovasc Care. 2012;1(4):275-80.

20. Kim BR, Park SJ, Shin HS, Jung YS, Rim H. Correlation between peripheral venous and arterial blood gas measurements in patients admitted to the intensive care unit: A single-center study. Kidney Res Clin Pract. 2013;32(1):32-8.

21. Kramer MS, Feinstein AR. Clinical biostatistics LIV. The biostatistics of concordance. Clin Pharmacol Ther. 1981;29:111-23.

22. Rudkin SE, Kahn CA, Oman JA, Dolich MO, Lotfipour S, Lush S, et al. Prospective correlation of arterial vs venous blood gas measurements in trauma patients. Am J Emerg Med. 2012;30(8):1371-7.