Agreement of pCO2 in venous to arterial blood gas conversion models in undifferentiated emergency patients
Abstract Background Venous blood gas sampling has replaced arterial sampling in many critically ill patients, though interpretation of venous pCO2 still remains a challenge. Lemoël et al., Farkas and Zeserson et al. have proposed models to estimate arterial pCO2 based on venous pCO2. Our objective w...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SpringerOpen
2023-11-01
|
| Series: | Intensive Care Medicine Experimental |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40635-023-00564-w |
| _version_ | 1797454156137496576 |
|---|---|
| author | Matthias Jörg Malin Öster Jens Wretborn Daniel B. Wilhelms |
| author_facet | Matthias Jörg Malin Öster Jens Wretborn Daniel B. Wilhelms |
| author_sort | Matthias Jörg |
| collection | DOAJ |
| description | Abstract Background Venous blood gas sampling has replaced arterial sampling in many critically ill patients, though interpretation of venous pCO2 still remains a challenge. Lemoël et al., Farkas and Zeserson et al. have proposed models to estimate arterial pCO2 based on venous pCO2. Our objective was to externally validate these models with a new dataset. This was a prospective cross-sectional study of consecutive adult patients with a clinical indication for blood gas analysis in an academic emergency department in Sweden. Agreement of pairs was reported as mean difference with limits of agreement (LoA). Vital signs and lead times were recorded. Results Two hundred and fifty blood gas pairs were collected consecutively between October 2021 and April 2022, 243 valid pairs were used in the final analysis [mean age 72.8 years (SD 17.8), 47% females]. Respiratory distress was the most common clinical indication (84% of all cases). The model of Farkas showed the best metrics with a mean difference between estimated and arterial pCO2 of − 0.11 mmHg (95% LoA − 6.86, + 6.63). For Lemoël the difference was 2.57 mmHg (95% LoA − 5.65, + 10.8), Zeserson 2.55 mmHg (95% LoA − 7.43, + 12.53). All three models showed a decrease in precision in patients with ongoing supplemental oxygen therapy. Conclusion Arterial pCO2 may be accurately estimated in most patients based on venous blood gas samples. Additional consideration is required in patients with hypo- or hypercapnia or oxygen therapy. Thus, conversion of venous pCO2 may be considered as an alternative to arterial blood gas sampling with the model of Farkas being the most accurate. |
| first_indexed | 2024-03-09T15:33:12Z |
| format | Article |
| id | doaj.art-75cb21324f084d4691bde949cded92d5 |
| institution | Directory Open Access Journal |
| issn | 2197-425X |
| language | English |
| last_indexed | 2024-03-09T15:33:12Z |
| publishDate | 2023-11-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Intensive Care Medicine Experimental |
| spelling | doaj.art-75cb21324f084d4691bde949cded92d52023-11-26T12:08:49ZengSpringerOpenIntensive Care Medicine Experimental2197-425X2023-11-011111810.1186/s40635-023-00564-wAgreement of pCO2 in venous to arterial blood gas conversion models in undifferentiated emergency patientsMatthias Jörg0Malin Öster1Jens Wretborn2Daniel B. Wilhelms3Department of Emergency Medicine, Sundsvall Regional HospitalDepartment of Emergency Medicine, Local Health Care Services in Central ÖstergötlandDepartment of Biomedical and Clinical Sciences, Linköping UniversityDepartment of Biomedical and Clinical Sciences, Linköping UniversityAbstract Background Venous blood gas sampling has replaced arterial sampling in many critically ill patients, though interpretation of venous pCO2 still remains a challenge. Lemoël et al., Farkas and Zeserson et al. have proposed models to estimate arterial pCO2 based on venous pCO2. Our objective was to externally validate these models with a new dataset. This was a prospective cross-sectional study of consecutive adult patients with a clinical indication for blood gas analysis in an academic emergency department in Sweden. Agreement of pairs was reported as mean difference with limits of agreement (LoA). Vital signs and lead times were recorded. Results Two hundred and fifty blood gas pairs were collected consecutively between October 2021 and April 2022, 243 valid pairs were used in the final analysis [mean age 72.8 years (SD 17.8), 47% females]. Respiratory distress was the most common clinical indication (84% of all cases). The model of Farkas showed the best metrics with a mean difference between estimated and arterial pCO2 of − 0.11 mmHg (95% LoA − 6.86, + 6.63). For Lemoël the difference was 2.57 mmHg (95% LoA − 5.65, + 10.8), Zeserson 2.55 mmHg (95% LoA − 7.43, + 12.53). All three models showed a decrease in precision in patients with ongoing supplemental oxygen therapy. Conclusion Arterial pCO2 may be accurately estimated in most patients based on venous blood gas samples. Additional consideration is required in patients with hypo- or hypercapnia or oxygen therapy. Thus, conversion of venous pCO2 may be considered as an alternative to arterial blood gas sampling with the model of Farkas being the most accurate.https://doi.org/10.1186/s40635-023-00564-wBlood gasConversionpCO2ArterialVenousEmergency department |
| spellingShingle | Matthias Jörg Malin Öster Jens Wretborn Daniel B. Wilhelms Agreement of pCO2 in venous to arterial blood gas conversion models in undifferentiated emergency patients Intensive Care Medicine Experimental Blood gas Conversion pCO2 Arterial Venous Emergency department |
| title | Agreement of pCO2 in venous to arterial blood gas conversion models in undifferentiated emergency patients |
| title_full | Agreement of pCO2 in venous to arterial blood gas conversion models in undifferentiated emergency patients |
| title_fullStr | Agreement of pCO2 in venous to arterial blood gas conversion models in undifferentiated emergency patients |
| title_full_unstemmed | Agreement of pCO2 in venous to arterial blood gas conversion models in undifferentiated emergency patients |
| title_short | Agreement of pCO2 in venous to arterial blood gas conversion models in undifferentiated emergency patients |
| title_sort | agreement of pco2 in venous to arterial blood gas conversion models in undifferentiated emergency patients |
| topic | Blood gas Conversion pCO2 Arterial Venous Emergency department |
| url | https://doi.org/10.1186/s40635-023-00564-w |
| work_keys_str_mv | AT matthiasjorg agreementofpco2invenoustoarterialbloodgasconversionmodelsinundifferentiatedemergencypatients AT malinoster agreementofpco2invenoustoarterialbloodgasconversionmodelsinundifferentiatedemergencypatients AT jenswretborn agreementofpco2invenoustoarterialbloodgasconversionmodelsinundifferentiatedemergencypatients AT danielbwilhelms agreementofpco2invenoustoarterialbloodgasconversionmodelsinundifferentiatedemergencypatients |