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.

Hdl Handle:
http://hdl.handle.net/10147/206375
Title:
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.
Authors:
O'Connor, T M; Barry, P J; Jahangir, A; Finn, C; Buckley, B M; El-Gammal, A
Affiliation:
Department of Respiratory Medicine, Mercy University Hospital, Cork, Ireland., terryoconnor@eircom.net
Citation:
Respiration. 2011;81(1):18-25. Epub 2010 Feb 4.
Journal:
Respiration; international review of thoracic diseases
Issue Date:
31-Jan-2012
URI:
http://hdl.handle.net/10147/206375
DOI:
10.1159/000281879
PubMed ID:
20134147
Abstract:
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:
eng
MeSH:
Aged; Aged, 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
ISSN:
1423-0356 (Electronic); 0025-7931 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorO'Connor, T Men_GB
dc.contributor.authorBarry, P Jen_GB
dc.contributor.authorJahangir, Aen_GB
dc.contributor.authorFinn, Cen_GB
dc.contributor.authorBuckley, B Men_GB
dc.contributor.authorEl-Gammal, Aen_GB
dc.date.accessioned2012-01-31T16:39:29Z-
dc.date.available2012-01-31T16:39:29Z-
dc.date.issued2012-01-31T16:39:29Z-
dc.identifier.citationRespiration. 2011;81(1):18-25. Epub 2010 Feb 4.en_GB
dc.identifier.issn1423-0356 (Electronic)en_GB
dc.identifier.issn0025-7931 (Linking)en_GB
dc.identifier.pmid20134147en_GB
dc.identifier.doi10.1159/000281879en_GB
dc.identifier.urihttp://hdl.handle.net/10147/206375-
dc.description.abstractBACKGROUND: 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.en_GB
dc.language.isoengen_GB
dc.subject.meshAgeden_GB
dc.subject.meshAged, 80 and overen_GB
dc.subject.meshAir Pollutionen_GB
dc.subject.meshArteries/metabolismen_GB
dc.subject.meshBlood Gas Analysis/standardsen_GB
dc.subject.meshCritical Pathways/standardsen_GB
dc.subject.meshDiagnostic Errors/*prevention & controlen_GB
dc.subject.meshDisease Progressionen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshHumansen_GB
dc.subject.meshHydrogen-Ion Concentrationen_GB
dc.subject.meshIrelanden_GB
dc.subject.meshLaboratories, Hospital/standardsen_GB
dc.subject.meshMaleen_GB
dc.subject.meshMiddle Ageden_GB
dc.subject.mesh*Pulmonary Disease, Chronic Obstructive/blood/diagnosisen_GB
dc.subject.meshReference Standardsen_GB
dc.subject.meshVeins/metabolismen_GB
dc.titleComparison 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.en_GB
dc.contributor.departmentDepartment of Respiratory Medicine, Mercy University Hospital, Cork, Ireland., terryoconnor@eircom.neten_GB
dc.identifier.journalRespiration; international review of thoracic diseasesen_GB
dc.description.provinceMunster-
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