Analysis of arterial blood gas values when discarding different volumes of blood samples in an arterial heparin blood collector during thoracoscopic surgery
Ontology highlight
ABSTRACT:
SUBMITTER: Xue P
PROVIDER: S-EPMC11250960 | biostudies-literature | 2024 Jan
REPOSITORIES: biostudies-literature
Similar Datasets
Project description:BackgroundArterial blood gases (ABG) are essential for assessment of patients with severe illness, but sampling is difficult in some settings and more painful than for peripheral venous blood gas (VBG). Venous to Arterial Conversion (v-TAC; OBIMedical ApS, Denmark) is a method to calculate ABG values from a VBG and pulse oximetry (SpO2). The aim was to validate v-TAC against ABG for measuring pH, carbon dioxide (pCO2) and oxygenation (pO2).MethodsOf 103 sample sets, 87 paired ABGs and VBGs with SpO2 from 46 inpatients eligible for ABG met strict sampling criteria. Agreement was evaluated using mean difference with 95% limits of agreement (LoA) and Bland-Altman plots.Resultsv-TAC had very high agreement with ABG for pH (mean diff(ABG-v-TAC) -0.001; 95% LoA -0.017 to 0.016), pCO2 (-0.14 kPa; 95% LoA -0.46 to 0.19) and moderate to high for pO2 (-0.28 kPa; 95% LoA -1.31 to 0.76). For detecting hypercapnia (PaCO2>6.0 kPa), v-TAC had sensitivity 100%, specificity 93.8% and accuracy 97%. The accuracy of v-TAC for detecting hypoxemia (PaO2<8.0 kPa) was comparable to that of pulse oximetry. Agreement with ABG was higher for v-TAC than for VBG for all analyses.ConclusionCalculated arterial blood gases (v-TAC) from a venous sample and pulse oximetry were comparable to ABG values and may be useful for evaluation of blood gases in clinical settings. This could reduce the logistic burden of arterial sampling, facilitate improved screening and follow-up and reduce patient pain.
| S-EPMC6461265 | biostudies-literature
Project description:Canine bronchomalacia (CBM) is a structural airway disease leading to chronic cough and intermittent respiratory distress, primarily affecting elderly dogs of small breeds. Results of blood gas analysis have been reported in dogs with several diseases, but not yet in those with CBM. Eleven dogs with CBM were recruited in this study. Most dogs presented with mild hypoxemia and normocapnia, and all with increased alveolar-arterial difference for O2 (A-aDO2). In computed tomography, abnormal lung patterns, such as atelectasis and parenchymal band, were detected in all dogs, consistent with the regions affected by CBM. We conclude that CBM causes abnormal lung patterns and results in impaired oxygenation. Blood gas analysis is a useful tool for detecting mild pulmonary lesions and concurrent CBM.
| S-EPMC6938372 | biostudies-literature
Project description:BackgroundThe benefits of laparoscopic surgery are well known. However, clinic and metabolic consequences of pneumoperitoneum, achieved by insufflation of gas carbon dioxide, are still debated. Cardiovascular system suffering due to the compression of intra-abdominal venous structures can cause life-threatening complications. Increased partial pressure of carbon dioxide induces metabolic acidosis with further vascular suffering. Pneumoperitoneum reduces the pulmonary exchange volumes and bring renal suffering.MethodsThe aim of this study is to evaluate the alterations in hemodynamic and hemogasanalysis parameters during the laparoscopic surgery at different pressure settings of pneumoperitoneum in order to assess the best pressure value.We evaluated and compared intraoperative hemodynamic and hemogasanalytic alterations in two groups of patients respectively subdue to laparoscopic cholecystectomy at a pneumoperitoneum pressure of 12 mmHg (group A) and at a pressure of 8 mmHg (group B).ResultsIn both groups, after the induction of anesthesia we observed a flexion in the heart rate, with no significant difference between the two groups. During the intervention, group A showed a significantly higher respiratory rate than the group B. The average blood pressure decreased mostly in group B. The oxygen saturation increased at the end of the procedure in group A, more than in the group B. The pH value was higher in group B. The hydrogen carbonate ion settled at lower levels in group A.ConclusionAlthough significant differences between the two groups were appreciated on several parameters, they were never of such magnitude to prefer the induction of pneumoperitoneum at 8 mmHg.
| S-EPMC9486856 | biostudies-literature
Project description:Onboard oxygen-generating systems (OBOGSs) provide increased inspired oxygen (FiO2) to mitigate the risk of neurologic injury in high altitude aviators. OBOGSs can deliver highly variable oxygen concentrations oscillating around a predetermined FiO2 set point, even when the aircraft cabin altitude is relatively stable. Steady-state exposure to 100% FiO2 evokes neurovascular vasoconstriction, diminished cerebral perfusion, and altered electroencephalographic activity. Whether non-steady-state FiO2 exposure leads to similar outcomes is unknown. This study characterized the physiologic responses to steady-state and non-steady-state FiO2 during normobaric and hypobaric environmental pressures emulating cockpit pressures within tactical aircraft. The participants received an indwelling radial arterial catheter while exposed to steady-state or non-steady-state FiO2 levels oscillating ± 15% of prescribed set points in a hypobaric chamber. Steady-state exposure to 21% FiO2 during normobaria produced arterial blood gas values within the anticipated ranges. Exposure to non-steady-state FiO2 led to PaO2 levels higher upon cessation of non-steady-state FiO2 than when measured during steady-state exposure. This pattern was consistent across all FiO2 ranges, at each barometric condition. Prefrontal cortical activation during cognitive testing was lower following exposure to non-steady-state FiO2 >50% and <100% during both normobaria and hypobaria of 494 mmHg. The serum analyte levels (IL-6, IP-10, MCP-1, MDC, IL-15, and VEGF-D) increased 48 h following the exposures. We found non-steady-state FiO2 levels >50% reduced prefrontal cortical brain activation during the cognitive challenge, consistent with an evoked pattern of neurovascular constriction and dilation.
| S-EPMC10969887 | biostudies-literature
Project description:Arterial blood gas (ABG) measurements at both maximum depth and at resurfacing prior to breathing have not previously been measured during free dives conducted to extreme depth in cold open-water conditions. An elite free diver was instrumented with a left radial arterial cannula connected to two sampling syringes through a low-volume splitting device. He performed two open-water dives to a depth of 60 m (197', 7 atmospheres absolute pressure) in the constant weight with fins competition format. ABG samples were drawn at 60 m (by a mixed-gas scuba diver) and again on resurfacing before breathing. An immersed surface static apnea, of identical length to the dives and with ABG sampling at identical times, was also performed. Both dives lasted approximately 2 min. Arterial partial pressure of oxygen ([Formula: see text]) increased during descent from an indicative baseline of 15.8 kPa (after hyperventilation and glossopharyngeal insufflation) to 42.8 and 33.3 kPa (dives 1 and 2) and decreased precipitously (to 8.2 and 8.6 kPa) during ascent. Arterial partial pressure of carbon dioxide ([Formula: see text]) also increased from a low indicative baseline of 2.8 kPa to 6.3 and 5.1 kPa on dives 1 and 2; an increase not explained by metabolic production of CO2 alone since [Formula: see text] actually decreased during ascent (to 5.2 and 4.5 kPa). Surface static apnea caused a steady decrease in [Formula: see text] and increase in [Formula: see text] without the inflections provoked by depth changes. Lung compression and expansion provoke significant changes in both [Formula: see text] and [Formula: see text] during rapid descent and ascent on a deep free dive. These changes generally support predictive hypotheses and previous findings in less extreme settings.NEW & NOTEWORTHY Arterial blood gas measurements at both maximum depth and the surface before breathing on the same dive have not previously been obtained during deep breath-hold dives in cold open-water conditions and competition dive format. Such measurements were obtained in two dives to 60 m (197') of 2 min duration. Changes in arterial oxygen and carbon dioxide (an increase during descent, and a decrease during ascent) support previous observations in less extreme dives and environments.
| S-EPMC8354821 | biostudies-literature
Project description:BACKGROUND:Pulse oximetry is widely used in the clinical setting. The purpose of this validation study was to investigate the level of agreement between oxygen saturations measured by pulse oximeter (SpO2) and arterial blood gas (SaO2) in a range of oximeters in clinical use in Australia and New Zealand. METHODS:Paired SpO2 and SaO2 measurements were collected from 400 patients in one Australian and two New Zealand hospitals. The ages of the patients ranged from 18 to 95 years. Bias and limits of agreement were estimated. Sensitivity and specificity for detecting hypoxaemia, defined as SaO2 < 90%, were also estimated. RESULTS:The majority of participants were recruited from the Outpatient, Ward or High Dependency Unit setting. Bias, oximeter-measured minus arterial blood gas-measured oxygen saturation, was - 1.2%, with limits of agreement - 4.4 to 2.0%. SpO2 was at least 4% lower than SaO2 for 10 (2.5%) of the participants and SpO2 was at least 4% higher than the SaO2 in 3 (0.8%) of the participants. None of the participants with a SpO2 ≥ 92% were hypoxaemic, defined as SaO2 < 90%. There were no clinically significant differences in oximetry accuracy in relation to clinical characteristics or oximeter brand. CONCLUSIONS:In the majority of the participants, pulse oximetry was an accurate method to assess SaO2 and had good performance in detecting hypoxaemia. However, in a small proportion of participants, differences between SaO2 and SpO2 could have clinical relevance in terms of patient monitoring and management. A SpO2 ≥ 92% indicates that hypoxaemia, defined as a SaO2 < 90%, is not present. TRIAL REGISTRATION:Australian and New Zealand Clinical Trials Registry (ACTRN12614001257651). Date of registration: 2/12/2014.
| S-EPMC6953261 | biostudies-literature
Project description:BackgroundArterial blood gas analysis is an important diagnostic tool in managing critically ill patients within the hospital. Whether prehospital application of this diagnostic modality contributes to more exact diagnoses and treatments in critically ill prehospital patients is unknown. The aim of this study was to establish whether access to arterial blood gas analysis increased the prehospital diagnostic accuracy of prehospital anaesthesiologists. Furthermore, we investigated whether prehospital blood gas analysis resulted in therapeutic interventions that would not have been carried out if the arterial blood gas analyser had not been available.MethodsIn a prospective randomised study, two groups of prehospital adult patients with acute critical illness were compared. All patients received standard prehospital care. In the intervention group, an arterial blood gas sample was analysed prehospitally. The primary outcome was the impact of blood gas analysis on the accuracy of prehospital diagnoses. Furthermore, we registered any therapeutic interventions that were carried out as a direct result of the blood gas analysis.ResultsA total of 310 patients were included in the study. Eighty-eight of these patients were subsequently excluded, primarily due to difficulties in obtaining post hoc consent or venous sampling or other technical difficulties. A total of 102 patients was analysed in the arterial blood gas group (ABG group), while 120 patients were analysed in the standard care group (noABG group). In 78 of the 102 patients in the ABG group, the prehospital physician reported that ABG analysis increased their perceived diagnostic precision. In 81 cases in the noABG group, the lack of arterial blood gas analysis was perceived to have decreased diagnostic accuracy. The claim that ABG analysis increased diagnostic accuracy could, however, not be substantiated as there was no difference in the number of un-specific diagnoses between the groups. Blood gas analysis increased the probability of targeting specific prehospital therapeutic interventions and led to 159 interventions, including intubation, ventilation and/or upgrading the level of urgency, in 71 ABG-group patients (p < 0.001).ConclusionAlthough prehospital arterial blood gas analysis did not improve the accuracy of the prehospital diagnoses assigned to patients, it significantly increased the quality of treatment provided to patients with acute critical illness.Trial registrationClinicalTrials.gov, NCT03006692 , retrospectively registered six months after first patient entry.
| S-EPMC6421666 | biostudies-literature
Project description:IntroductionBlood gas analysis is an important test for making quick and important clinical decisions, and it is recommended that a dedicated syringe that contains heparin be used to measure blood gas. We hypothesized that a plastic syringe could be used as a less-expensive substitute for a dedicated syringe, given that the test is performed immediately after collection.MethodsThis single-center, prospective, observational study involved patients admitted to the Kanoya Medical Center (Kagoshima, Japan) between July 2020 and March 2021, who were requiring blood gas analysis using a dedicated syringe under arterial line (A-line) monitoring. There were no exclusion criteria. Two samples were collected from each patient using a dedicated syringe, and one sample was collected using a plastic syringe. To determine clinical substitutability, Bland-Altman analysis was performed.ResultsA total of 60 samples from 20 consecutive patients were collected and assayed. The mean patient age was 72 years, and 75% patients were men. The 95% limit of agreement for pH, PCO2, PO2, Na, K, Ca, and SO2 were similar for both dedicated and plastic syringes. HCO3 and BE were significantly higher in the samples taken with plastic syringes, whereas Hb and Ht could not be measured accurately with any syringe.ConclusionsThe use of plastic syringes in place of dedicated syringes is generally considered acceptable for most items considering that measurement is performed within 3 min of collection, and the cost of medical materials may be reduced. Regardless of the type of syringe, caution should be exercised in interpreting the results of measuring Hb and Ht using a blood gas analyzer.
| S-EPMC10169280 | biostudies-literature
Project description:Heparin is an indispensable drug in anticoagulation therapy but with a narrow therapeutic window, which dictates regular testing and dose adjustment. However, current monitoring tools have a long turnaround time or are operator intensive. In this work, we describe a cellulose-based photoacoustic sensor for heparin. The sensors have a turnaround time of 6 min for whole blood samples and 3 min for plasma samples regardless of heparin concentration. These sensors have a limit of detection of 0.28 U/ml heparin in human plasma and 0.29 U/ml in whole blood with a linear response (Pearson's r = 0.99) from 0 to 2 U/ml heparin in plasma and blood samples. The relative standard deviation was < 12.5% in plasma and < 17.5% in whole blood. This approach was validated with heparin-spiked whole human blood and had a linear correlation with the activated partial thromboplastin time (aPTT) (r = 0.99). We then studied 16 sets of clinical samples-these had a linear correlation with the activated clotting time (ACT) (Pearson's r = 0.86, P < 0.0001). The photoacoustic signal was also validated against the cumulative heparin dose (Pearson's r = 0.71, P < 0.0001). This approach could have applications in bed-side heparin assays for continuous heparin monitoring.
| S-EPMC6357780 | biostudies-literature
Project description:ObjectiveScreening criteria for neonatal encephalopathy remain a complex combination of subjective and objective criteria. We examine the utility of universal cord blood gas testing and mandatory encephalopathy evaluation for infants with pH ≤7.10 on umbilical cord arterial blood gas (cABG) as a single screening measure for timely identification of moderate/severe encephalopathy.Design, setting, patientsInfants born at a single centre between 2008 and 2015, who were ≥36 weeks, had no congenital anomalies and had a cABG pH ≤7.10 were identified for a retrospective cohort study. Maternal/perinatal and patient factors were collected.Results27 028 infants were born during the study period; 412 met all inclusion criteria. Of those, 35/85 infants with pH <7.00 and 34/327 infants with pH between 7.00 and 7.10 had moderate/severe encephalopathy. Encephalopathy was identified on the basis of pH and examination alone (no other perinatal criteria present) in 5/35 and 13/34 infants in the two pH groups, respectively.A cABG pH threshold of ≤7.10 was associated with a sensitivity of 74.2% and a specificity of 98.7% for detection of moderate/severe encephalopathy. Based on these data, 25 infants with cABG pH between 7.00 and 7.10 will need to be screened to identify one neonate with moderate/severe encephalopathy, who might have otherwise been missed using conventional screening, a 15% increase in appropriate selection and treatment over current methods.ConclusionUniversal cord blood gas screening with a pH threshold ≤7.10 and mandatory encephalopathy examination results in greater detection of infants with moderate/severe encephalopathy and timely initiation of therapeutic hypothermia.
| S-EPMC6192544 | biostudies-literature