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Tang S, Mei Z, Huang D, Liu L, Yang L, Yin D, Hu L. Comparative analysis of hemoglobin, potassium, sodium, and glucose in arterial blood gas and venous blood of patients with COPD. Sci Rep 2024; 14:5194. [PMID: 38431760 PMCID: PMC10908784 DOI: 10.1038/s41598-024-55992-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 02/29/2024] [Indexed: 03/05/2024] Open
Abstract
The study aims to assess the accuracy of the arterial blood gas (ABG) analysis in measuring hemoglobin, potassium, sodium, and glucose concentrations in comparison to standard venous blood analysis among patients diagnosed with chronic obstructive pulmonary disease (COPD). From January to March 2023, results of ABG analysis and simultaneous venous blood sampling among patients with COPD were retrospectively compared, without any intervention being applied between the two methods. The differences in hemoglobin, potassium, sodium, and glucose concentrations were assessed using a statistical software program (R software). There were significant differences in the mean concentrations of hemoglobin (p < 0.001), potassium (p < 0.001), and sodium (p = 0.001) between the results from ABG and standard venous blood analysis. However, the magnitude of the difference was within the total error allowance (TEa) of the United States of Clinical Laboratory Improvement Amendments (US-CLIA). As for the innovatively studied glucose concentrations, a statistically significant difference between the results obtained from ABG (7.8 ± 3.00) mmol·L-1 and venous blood (6.72 ± 2.44) mmol·L-1 was noted (p < 0.001), with the difference exceeding the TEa of US-CLIA. A linear relationship between venous blood glucose and ABG was obtained: venous blood glucose (mmol·L-1) = - 0.487 + 0.923 × ABG glucose (mmol·L-1), with R2 of 0.882. The hemoglobin, potassium, and sodium concentrations in ABG were reliable for guiding treatment in managing COPD emergencies. However, the ABG analysis of glucose was significantly higher as compared to venous blood glucose, and there was a positive correlation between the two methods. Thus, a linear regression equation in this study combined with ABG analysis could be helpful in quickly estimating venous blood glucose during COPD emergency treatment before the standard venous blood glucose was available from the medical laboratory.
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Affiliation(s)
- Sitian Tang
- People's Hospital of Chongqing Liang Jiang New Area, No. 199 Ren Xing Road, Chongqing, 401135, People's Republic of China
| | - Zhu Mei
- People's Hospital of Chongqing Liang Jiang New Area, No. 199 Ren Xing Road, Chongqing, 401135, People's Republic of China
| | - Dongmei Huang
- People's Hospital of Chongqing Liang Jiang New Area, No. 199 Ren Xing Road, Chongqing, 401135, People's Republic of China
| | - Ling Liu
- People's Hospital of Chongqing Liang Jiang New Area, No. 199 Ren Xing Road, Chongqing, 401135, People's Republic of China
| | - Lunyu Yang
- People's Hospital of Chongqing Liang Jiang New Area, No. 199 Ren Xing Road, Chongqing, 401135, People's Republic of China
| | - Dan Yin
- People's Hospital of Chongqing Liang Jiang New Area, No. 199 Ren Xing Road, Chongqing, 401135, People's Republic of China.
| | - Liyi Hu
- People's Hospital of Chongqing Liang Jiang New Area, No. 199 Ren Xing Road, Chongqing, 401135, People's Republic of China.
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Thy SA, Johansen AO, Thy A, Sørensen HH, Mølgaard J, Foss NB, Toft P, Meyhoff CS, Aasvang EK. Associations between clinical interventions and transcutaneous blood gas values in postoperative patients. J Clin Monit Comput 2023; 37:1255-1264. [PMID: 36808596 DOI: 10.1007/s10877-023-00982-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 01/29/2023] [Indexed: 02/21/2023]
Abstract
PURPOSE Postoperative monitoring of circulation and respiration is pivotal to guide intervention strategies and ensure patient outcomes. Transcutaneous blood gas monitoring (TCM) may allow for noninvasive assessment of changes in cardiopulmonary function after surgery, including a more direct assessment of local micro-perfusion and metabolism. To form the basis for studies assessing the clinical impact of TCM complication detection and goal-directed-therapy, we examined the association between clinical interventions in the postoperative period and changes in transcutaneous blood gasses. METHODS Two-hundred adult patients who have had major surgery were enrolled prospectively and monitored with transcutaneous blood gas measurements (oxygen (TcPO2) and carbon dioxide (TcPCO2)) for 2 h in the post anaesthesia care unit, with recording of all clinical interventions. The primary outcome was changes in TcPO2, secondarily TcPCO2, from 5 min before a clinical intervention versus 5 min after, analysed with paired t-test. RESULTS Data from 190 patients with 686 interventions were analysed. During clinical interventions, a mean change in TcPO2 of 0.99 mmHg (95% CI-1.79-0.2, p = 0.015) and TcPCO2 of-0.67 mmHg (95% CI 0.36-0.98, p < 0.001) was detected. CONCLUSION Clinical interventions resulted in significant changes in transcutaneous oxygen and carbon dioxide. These findings suggest future studies to assess the clinical value of changes in transcutaneous PO2 and PCO2 in a postoperative setting. TRIAL REGISTRY Clinical trial number: NCT04735380. CLINICAL TRIAL REGISTRY https://clinicaltrials.gov/ct2/show/NCT04735380.
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Affiliation(s)
- Sandra A Thy
- Department of Anesthesiology, Center for Cancer and Organ Dysfunction, Copenhagen University Hospital-Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.
- Department of Anesthesiology, Odense University Hospital and Faculty of Health Science, University of Southern Denmark, Odense, Denmark.
| | - Andreas O Johansen
- Department of Anaesthesia and Intensive Care, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - André Thy
- Department of Anesthesiology, Center for Cancer and Organ Dysfunction, Copenhagen University Hospital-Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Henrik H Sørensen
- Department of Anesthesiology, Center for Cancer and Organ Dysfunction, Copenhagen University Hospital-Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Jesper Mølgaard
- Department of Anesthesiology, Center for Cancer and Organ Dysfunction, Copenhagen University Hospital-Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Nicolai B Foss
- Department of Anesthesia and Intensive Care, Copenhagen University Hospital-Amager and Hvidovre, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Palle Toft
- Department of Anesthesiology, Odense University Hospital and Faculty of Health Science, University of Southern Denmark, Odense, Denmark
| | - Christian S Meyhoff
- Department of Anaesthesia and Intensive Care, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Eske K Aasvang
- Department of Anesthesiology, Center for Cancer and Organ Dysfunction, Copenhagen University Hospital-Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Farenden S, Chung Y, Cui A, Ferguson I. Prospective, observational study investigating the level of agreement between transcutaneous and invasive carbon dioxide measurements in critically ill emergency department patients. Emerg Med J 2023; 40:646-650. [PMID: 37479485 DOI: 10.1136/emermed-2022-212465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 06/16/2023] [Indexed: 07/23/2023]
Abstract
BACKGROUND Transcutaneous carbon dioxide (Ptcco2) measurement is a non-invasive surrogate marker for arterial carbon dioxide (Paco2), which requires invasive arterial blood sampling. Use of Ptcco2 has been examined in different clinical settings, however, most existing evidence in the adult emergency department (ED) setting shows insufficient agreement between the measurements. This study assessed the level of agreement between Ptcco2 and Paco2 in undifferentiated adult ED patients across multiple timepoints. METHODS This prospective observational study (study period 2020-2021) assessed paired Ptcco2 and Paco2 measurements at four consecutive timepoints (0, 30, 60 and 90 min) in adult (aged 18 years or over) Australian ED patients requiring hospital admission and arterial catheter insertion. Agreement between the pairs was assessed using Bland-Altman analysis. It was prospectively determined by expert consensus that limits of ±4 mm Hg would be a clinically acceptable level of agreement between Ptcco2 and Paco2. RESULTS During the study period 168 paired Ptcco2 and Paco2 readings were taken from 42 adult ED patients. Bland-Altman analysis showed a mean Ptcco2 reading 3.85 mm Hg higher than Paco2, although at each timepoint the 95% CIs breached the limit of 4 mm Hg difference. In addition, only 66% (111/168) of results fell within the clinically acceptable range. CONCLUSION The level of agreement between Ptcco2 and Paco2 measurements may not be sufficiently precise for the adoption of Ptcco2 monitoring in patients presenting to the ED.
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Affiliation(s)
- Scott Farenden
- Emergency Department, Liverpool Hospital, Liverpool, New South Wales, Australia
| | - Yewon Chung
- Department of Respiratory and Sleep Medicine, Liverpool Hospital, Liverpool, New South Wales, Australia
- South Western Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia
| | - Amy Cui
- Emergency Department, Liverpool Hospital, Liverpool, New South Wales, Australia
| | - Ian Ferguson
- Emergency Department, Liverpool Hospital, Liverpool, New South Wales, Australia
- Ambulance Service of NSW, Rozelle, New South Wales, Australia
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Abuzinadah AR, Almalki AK, Almuteeri RZ, Althalabi RH, Sahli HA, Hayash FA, Alrayiqi RH, Makkawi S, Maglan A, Alamoudi LO, Alamri NM, Alsaati MH, Alshareef AA, Aljereish SS, Bamaga AK, Alhejaili F, Abulaban AA, Alanazy MH. Utility of Initial Arterial Blood Gas in Neuromuscular versus Non-Neuromuscular Acute Respiratory Failure in Intensive Care Unit Patients. J Clin Med 2022; 11:jcm11164926. [PMID: 36013163 PMCID: PMC9410118 DOI: 10.3390/jcm11164926] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 08/12/2022] [Accepted: 08/15/2022] [Indexed: 12/01/2022] Open
Abstract
Background: The arterial blood gas (ABG) parameters of patients admitted to intensive care units (ICUs) with acute neuromuscular respiratory failure (NMRF) and non-NMRF have not been defined or compared in the literature. Methods: We retrospectively collected the initial ABG parameters (pH, PaCO2, PaO2, and HCO3) of patients admitted to ICUs with acute respiratory failure. We compared ABG parameter ranges and the prevalence of abnormalities in NMRF versus non-NMRF and its categories, including primary pulmonary disease (PPD) (chronic obstructive pulmonary disease, asthma, and bronchiectasis), pneumonia, and pulmonary edema. Results: We included 287 patients (NMRF, n = 69; non-NMRF, n = 218). The difference between NMRF and non-NMRF included the median (interquartile range (IQR)) of pH (7.39 (7.32−7.43), 7.33 (7.22−7.39), p < 0.001), PaO2 (86.9 (71.4−123), 79.6 (64.6−99.1) mmHg, p = 0.02), and HCO3 (24.85 (22.9−27.8), 23.4 (19.4−26.8) mmol/L, p = 0.006). We found differences in the median of PaCO2 in NMRF (41.5 mmHg) versus PPD (63.3 mmHg), PaO2 in NMRF (86.9 mmHg) versus pneumonia (74.3 mmHg), and HCO3 in NMRF (24.8 mmol/L) versus pulmonary edema (20.9 mmol/L) (all p < 0.01). NMRF compared to non-NMRF patients had a lower frequency of hypercarbia (24.6% versus 39.9%) and hypoxia (33.8% versus 50.5%) (all p < 0.05). NMRF compared to PPD patients had lower frequency of combined hypoxia and hypercarbia (13.2% versus 37.8%) but more frequently isolated high bicarbonate (33.8% versus 8.9%) (all p < 0.001). Conclusions: The ranges of ABG changes in NMRF patients differed from those of non-NMRF patients, with a greater reduction in PaO2 in non-NMRF than in NMRF patients. Combined hypoxemia and hypercarbia were most frequent in PPD patients, whereas isolated high bicarbonate was most frequent in NMRF patients.
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Affiliation(s)
- Ahmad R. Abuzinadah
- Neurology Division, Internal Medicine Department, Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
- Neuromuscular Medicine Unit, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah 21589, Saudi Arabia
- Correspondence: ; Tel.: +966-555987830; Fax: +966-126400855
| | | | | | | | | | | | | | - Seraj Makkawi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah 22384, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah 22384, Saudi Arabia
- Department of Medicine, Ministry of the National Guard-Health Affairs, Jeddah 22384, Saudi Arabia
| | - Alaa Maglan
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah 22384, Saudi Arabia
| | - Loujen O. Alamoudi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah 22384, Saudi Arabia
| | - Noof M. Alamri
- Neurology Division, Department of Medicine, Ministry of the National Guard-Health Affairs, Riyadh 11426, Saudi Arabia
| | - Maha H. Alsaati
- Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Aysha A. Alshareef
- Neurology Division, Internal Medicine Department, Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
- Neuromuscular Medicine Unit, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Sultan Saeed Aljereish
- Department of Internal Medicine, King Saud University Medical City, College of Medicine, King Saud University, Riyadh 11472, Saudi Arabia
| | - Ahmed K. Bamaga
- Neurology Division, Pediatric Department, King Abdulaziz University Hospital, Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Faris Alhejaili
- Pulmonology Division, Internal Medicine Department, King Abdulaziz University Hospital, Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Ahmad Abdulaziz Abulaban
- Neurology Division, Department of Medicine, Ministry of the National Guard-Health Affairs, Riyadh 11426, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh 11426, Saudi Arabia
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh 11426, Saudi Arabia
| | - Mohammed H. Alanazy
- Department of Internal Medicine, King Saud University Medical City, College of Medicine, King Saud University, Riyadh 11472, Saudi Arabia
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