Indian Journal of Critical Care Medicine

Register      Login

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue

Online First

Archive
Related articles

VOLUME 23 , ISSUE 6 ( June, 2019 ) > List of Articles

Original Article

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

Mubina Begum Bijapur, Nazeer Ahmed Kudligi, Shaik Asma

Keywords : Agreement, Arterial blood gas analysis, Central venous blood, Correlation, Electrolytes

Citation Information : Bijapur MB, Kudligi NA, Asma S. 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. Indian J Crit Care Med 2019; 23 (6):258-262.

DOI: 10.5005/jp-journals-10071-23176

License: CC BY-NC 4.0

Published Online: 01-06-2019

Copyright Statement:  Copyright © 2019; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Aims: Arterial blood gas (ABG) analysis is a frequently ordered test in intensive care unit (ICU) and can analyze electrolyte in addition to pH and blood gases. Venous blood gas (VBG) analysis is a safer procedure and may be an alternative for ABG. Electrolyte estimation by auto analyzer usually takes 20–30 minutes. This study was aimed to investigate the correlation of pH, PCO2, bicarbonate, sodium, potassium, and chloride (electrolytes) between ABG and central VBG in ICU patients. Materials and methods: This was a prospective observational study conducted in medical college hospital ICU. Adult patients requiring ABG and electrolyte estimation as a part of their clinical care were consecutively included in the study. Patients having any intravenous infusion or who were pregnant were excluded. Venous samples were taken within 2 minutes of arterial sampling from in situ central line. Data were analyzed using Bland-Altman methods. Results: A total of 110 patient\'s paired blood samples were analyzed. The mean difference between arterial and central venous values of pH, PCO2, bicarbonate, sodium, potassium, and chloride was 0.04 units, –5.84 mm Hg, 0.89 mmol/L, –1.8 mEq/L, –0.04 mEq/L, and –0.89 mEq/L, respectively. The correlation coefficients for pH, PCO2, HCO3–, sodium, potassium, and chloride were 0.799, 0.831, 0.892, 0.652, 0.599 and 0.730, respectively. Limits of agreement (95%) were within acceptable limits. Conclusion: Central venous pH, PCO2, and bicarbonate may be an acceptable substitute for ABG in patients admitted in the ICU. However caution should be exercised while applying electrolyte measurements.


PDF Share
  1. Mortenson JD. Clinical sequelae from arterial needle puncture, cannulation, and incision. Circulation 1967;35:1118–1123.
  2. Lee JW. Fluid and electrolyte disturbances in critically ill patients. Electrolyte Blood Press.2010;8:72–81. doi: 10.5049/EBP.2010.8.2.72
  3. Treger R, Pirouz S, Kamangar N, Corry D. Agreement between central venous and arterial blood gas measurements in the intensive care unit. Clin J Am Soc Nephrol 2010; 5:390–394. doi: 10.2215/CJN.00330109
  4. Awasthi S, Rani R, Malviya D. Peripheral venous blood gas analysis: An alternative to arterial blood gas analysis for initial assessment and resuscitation in emergency and intensive care unit patients. Anesth Essays Res 2013;7:355–358. doi: 10.4103/0259-1162.123234
  5. Johnston HLM, Murphy R. Agreement between an arterial blood gas analyser and avenous blood analyser in the measurement of potassium inpatients in cardiac arrest. Emerg Med J. 2005; 22:269–271. doi: 10.1136/emj.2003.013599
  6. Jain A, Subhan I, Joshi M. Comparison of the point-of-care blood gas analyser versus the laboratory auto-analyser for the measurement of electrolytes. Int J Emerg Med. 2009;2:117–120. doi: 10.1007/s12245- 009-0091-1
  7. Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986;1:307– 310.
  8. AARC clinical practice guidelines. Sampling for arterial blood gas analysis. American Association for Respiratory Care. Respir Care 1992;37;913–917.
  9. Middleton P, Kelly AM, Brown J, Robertson M. Agreement between arterial and central venous values for pH, bicarbonate, base excess and lactate. Emerg Med J 2006;23:622–624. DOI: 10.1136/emj.2006.035915
  10. Kim BR, Park SJ, Shin HS, Jung YS, Rim H. Correlation between peripheral venous and arterial gas measurements in patients admitted to the intensive care unit: A single-center study. Kidney Res Clin Pract 2013;32:32–38. doi: 10.1016/j.krcp.2013.01.002
  11. Rang LC, Murray HE, Wells GA, Macgougan CK. Can peripheral venous blood gases replace arterial blood gases in emergency department patients? CJEM 2002;4:7–15
  12. Nanda SK, Ray L, Dinakaran A. Agreement of arterial sodium and arterial potassium levels with venous sodium and venous potassium in patients admitted to intensive care unit. J Clin Diagn Res. 2015; 9(2):28–30. doi: 10.7860/JCDR/2015/12418.5602
  13. Wongyingsinn M, Suksuriyayothin S. Use of rapid ABG analyser in measurement of potassium concentration: does it agree with venous potassium concentration? J Med Assoc Thai. 2009;92:925–929.
  14. Flegar-Mestric Z, Perkov. S. Comparability of point-of-care wholeblood electrolyte and substrate testing using a stat profile critical care xpress analyser and standard laboratory methods. Clin Chem Lab Med. 2006;44:898–903. doi: 10.1515/CCLM.2006.148
  15. Jain A, Subhan I, Joshi M. Comparison of the point of care blood gas analyser versus laboratory auto analyser for the measurement of electrolytes. Int J Emerg Med. 2009;2:117–120. doi: 10.1007/s12245- 009-0091-1.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.