Comparison of arterial and venous blood gases and the effects of analysis delay and air contamination on arterial samples in patients with chronic obstructive pulmonary disease and healthy controls.
Affiliation
Department of Respiratory Medicine, Mercy University Hospital, Cork, Ireland., terryoconnor@eircom.netIssue Date
2012-01-31T16:39:29ZMeSH
AgedAged, 80 and over
Air Pollution
Arteries/metabolism
Blood Gas Analysis/standards
Critical Pathways/standards
Diagnostic Errors/*prevention & control
Disease Progression
Female
Humans
Hydrogen-Ion Concentration
Ireland
Laboratories, Hospital/standards
Male
Middle Aged
*Pulmonary Disease, Chronic Obstructive/blood/diagnosis
Reference Standards
Veins/metabolism
Metadata
Show full item recordCitation
Respiration. 2011;81(1):18-25. Epub 2010 Feb 4.Journal
Respiration; international review of thoracic diseasesDOI
10.1159/000281879PubMed ID
20134147Abstract
BACKGROUND: Arterial blood gases (ABGs) are often sampled incorrectly, leading to a 'mixed' or venous sample. Delays in analysis and air contamination are common. OBJECTIVES: We measured the effects of these errors in patients with chronic obstructive pulmonary disease (COPD) exacerbations and controls. METHODS: Arterial and venous samples were analyzed from 30 patients with COPD exacerbation and 30 controls. Venous samples were analysed immediately and arterial samples separated into non-air-contaminated and air-contaminated specimens and analysed at 0, 30, 60, 90 and 180 min. RESULTS: Mean venous pH was 7.371 and arterial pH was 7.407 (p < 0.0001). There was a correlation between venous and arterial pH (r = 0.5347, p < 0.0001). The regression equation to predict arterial pH was: arterial pH = 4.2289 + 0.43113 . venous pH. There were no clinically significant differences in arterial PO associated with analysis delay. A statistically significant decline in pH was detected at 30 min in patients with COPD exacerbation (p = 0.0042) and 90 min in controls (p < 0.0001). A clinically significant decline in pH emerged at 73 min in patients with COPD exacerbation and 87 min in controls. Air contamination was associated with a clinically significant increase in PO in all samples, including those that were immediately analyzed. CONCLUSIONS: Arterial and venous pH differ significantly. Venous pH cannot accurately replace arterial pH. Temporal delays in ABG analysis result in a significant decline in measured pH. ABGs should be analysed within 30 min. Air contamination leads to an immediate increase in measured PO, indicating that air-contaminated ABGs should be discarded.Language
engISSN
1423-0356 (Electronic)0025-7931 (Linking)
ae974a485f413a2113503eed53cd6c53
10.1159/000281879
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