Correlation and agreement between arterial and venous blood gas analysis in patients with hypotension—an emergency department-based cross-sectional study
Abstract Background Blood gas analysis is integral to assessing emergency department (ED) patients with acute respiratory or metabolic disease. Arterial blood gas (ABG) is the gold standard for oxygenation, ventilation, and acid–base status but is painful to obtain. Peripheral venous blood gas (VBG)...
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| Format: | Article |
| Language: | English |
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BMC
2023-03-01
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| Series: | International Journal of Emergency Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12245-023-00486-0 |
| _version_ | 1827985272319508480 |
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| author | Hari Prasad Nagasubramanyam Vempalli Naman Agrawal U. N. Ajun Ajmal Salam Soumya Subhra Datta Ashutosh Singhal Nishant Ranjan P. P. Shabeeba Sherin G. Sundareshan |
| author_facet | Hari Prasad Nagasubramanyam Vempalli Naman Agrawal U. N. Ajun Ajmal Salam Soumya Subhra Datta Ashutosh Singhal Nishant Ranjan P. P. Shabeeba Sherin G. Sundareshan |
| author_sort | Hari Prasad |
| collection | DOAJ |
| description | Abstract Background Blood gas analysis is integral to assessing emergency department (ED) patients with acute respiratory or metabolic disease. Arterial blood gas (ABG) is the gold standard for oxygenation, ventilation, and acid–base status but is painful to obtain. Peripheral venous blood gas (VBG) is a valuable alternative as it is less painful and easy to collect. The comparability of ABG and VBG was studied in various conditions. But in hypotension, previous findings were inconsistent. So, we studied the correlation and agreement between ABG and VBG in hypotensive patients. Methodology The study was conducted at the emergency department of a tertiary healthcare center in Northern India. Patients with hypotension above 18 years who satisfied the inclusion criteria were clinically evaluated. Patients who require ABG as a part of routine care were sampled. ABG was collected from the radial artery. VBG was obtained from the cubital or dorsal hand veins. Both samples were collected within 10 min and were analyzed. All ABG and VBG variables were entered in premade proforma. The patient was then treated and disposed of according to institutional protocol. Results A total of 250 patients were enrolled. The mean age was 53.25 ± 15.71 years. 56.8% were male. The study included 45.6% septic, 34.4% hypovolemic, 18% cardiogenic, and 2% obstructive shock patients. The study found a strong correlation and agreement for ABG and VBG pH, pCO2, HCO3, lactate, sodium, potassium, chloride, ionized calcium, blood urea nitrogen, base excess, and arterial/alveolar oxygen ratio. Hence, regression equations were made for the aforementioned. There was no correlation observed between ABG and VBG pO2 and SpO2. Our study concluded that VBG could be a reasonable alternative for ABG in hypotensive patients. We can also mathematically predict values of ABG from VBG using regression equations derived. Conclusions ABG sampling causes most unpleasant experiences to patients and is associated with complications like arterial injury, thrombosis, air or clotted-blood embolism, arterial occlusion, hematoma, aneurysm formation, and reflex sympathetic dystrophy. The study has shown strong correlations and agreements for most ABG and VBG parameters and can predict ABG mathematically using regression formulas formulated from VBG. This will decrease needle stick injury, consume less time, and make blood gas evaluation easy in hypotensive settings. |
| first_indexed | 2024-04-09T23:12:16Z |
| format | Article |
| id | doaj.art-b8091cb763ac44dab98428724088fe6b |
| institution | Directory Open Access Journal |
| issn | 1865-1380 |
| language | English |
| last_indexed | 2024-04-09T23:12:16Z |
| publishDate | 2023-03-01 |
| publisher | BMC |
| record_format | Article |
| series | International Journal of Emergency Medicine |
| spelling | doaj.art-b8091cb763ac44dab98428724088fe6b2023-03-22T10:20:28ZengBMCInternational Journal of Emergency Medicine1865-13802023-03-0116111510.1186/s12245-023-00486-0Correlation and agreement between arterial and venous blood gas analysis in patients with hypotension—an emergency department-based cross-sectional studyHari Prasad0Nagasubramanyam Vempalli1Naman Agrawal2U. N. Ajun3Ajmal Salam4Soumya Subhra Datta5Ashutosh Singhal6Nishant Ranjan7P. P. Shabeeba Sherin8G. Sundareshan9Department of Emergency Medicine, All India Institute of Medical Sciences RishikeshDepartment of Emergency Medicine, All India Institute of Medical Sciences RishikeshDepartment of Emergency Medicine, All India Institute of Medical Sciences RaipurDepartment of Community and Family Medicine, All India Institute of Medical Sciences RishikeshDepartment of Paediatrics, All India Institute of Medical Sciences RishikeshDepartment of Emergency Medicine, All India Institute of Medical Sciences RishikeshDepartment of Emergency Medicine, All India Institute of Medical Sciences RishikeshDepartment of Emergency Medicine, Tata Motors HospitalDepartment of Physical Medicine and Resuscitation, All India Institute of Medical Sciences RishikeshDepartment of Radiodiagnosis, All India Institute of Medical Sciences RishikeshAbstract Background Blood gas analysis is integral to assessing emergency department (ED) patients with acute respiratory or metabolic disease. Arterial blood gas (ABG) is the gold standard for oxygenation, ventilation, and acid–base status but is painful to obtain. Peripheral venous blood gas (VBG) is a valuable alternative as it is less painful and easy to collect. The comparability of ABG and VBG was studied in various conditions. But in hypotension, previous findings were inconsistent. So, we studied the correlation and agreement between ABG and VBG in hypotensive patients. Methodology The study was conducted at the emergency department of a tertiary healthcare center in Northern India. Patients with hypotension above 18 years who satisfied the inclusion criteria were clinically evaluated. Patients who require ABG as a part of routine care were sampled. ABG was collected from the radial artery. VBG was obtained from the cubital or dorsal hand veins. Both samples were collected within 10 min and were analyzed. All ABG and VBG variables were entered in premade proforma. The patient was then treated and disposed of according to institutional protocol. Results A total of 250 patients were enrolled. The mean age was 53.25 ± 15.71 years. 56.8% were male. The study included 45.6% septic, 34.4% hypovolemic, 18% cardiogenic, and 2% obstructive shock patients. The study found a strong correlation and agreement for ABG and VBG pH, pCO2, HCO3, lactate, sodium, potassium, chloride, ionized calcium, blood urea nitrogen, base excess, and arterial/alveolar oxygen ratio. Hence, regression equations were made for the aforementioned. There was no correlation observed between ABG and VBG pO2 and SpO2. Our study concluded that VBG could be a reasonable alternative for ABG in hypotensive patients. We can also mathematically predict values of ABG from VBG using regression equations derived. Conclusions ABG sampling causes most unpleasant experiences to patients and is associated with complications like arterial injury, thrombosis, air or clotted-blood embolism, arterial occlusion, hematoma, aneurysm formation, and reflex sympathetic dystrophy. The study has shown strong correlations and agreements for most ABG and VBG parameters and can predict ABG mathematically using regression formulas formulated from VBG. This will decrease needle stick injury, consume less time, and make blood gas evaluation easy in hypotensive settings.https://doi.org/10.1186/s12245-023-00486-0Blood gas analysisEmergencyHypotensionOxygenationShock |
| spellingShingle | Hari Prasad Nagasubramanyam Vempalli Naman Agrawal U. N. Ajun Ajmal Salam Soumya Subhra Datta Ashutosh Singhal Nishant Ranjan P. P. Shabeeba Sherin G. Sundareshan Correlation and agreement between arterial and venous blood gas analysis in patients with hypotension—an emergency department-based cross-sectional study International Journal of Emergency Medicine Blood gas analysis Emergency Hypotension Oxygenation Shock |
| title | Correlation and agreement between arterial and venous blood gas analysis in patients with hypotension—an emergency department-based cross-sectional study |
| title_full | Correlation and agreement between arterial and venous blood gas analysis in patients with hypotension—an emergency department-based cross-sectional study |
| title_fullStr | Correlation and agreement between arterial and venous blood gas analysis in patients with hypotension—an emergency department-based cross-sectional study |
| title_full_unstemmed | Correlation and agreement between arterial and venous blood gas analysis in patients with hypotension—an emergency department-based cross-sectional study |
| title_short | Correlation and agreement between arterial and venous blood gas analysis in patients with hypotension—an emergency department-based cross-sectional study |
| title_sort | correlation and agreement between arterial and venous blood gas analysis in patients with hypotension an emergency department based cross sectional study |
| topic | Blood gas analysis Emergency Hypotension Oxygenation Shock |
| url | https://doi.org/10.1186/s12245-023-00486-0 |
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