Correlation of Central Venous and Arterial Blood Gas Measurements in Mechanically Ventilated Trauma Patients
HYPOTHESIS Central venous blood gas (VBG) measurements of pH, PCO2, and base excess can be substituted for the same values obtained from an arterial blood gas (ABG) analysis in mechanically ventilated trauma patients, obviating the need for arterial puncture. DESIGN AND SETTING Prospective compariso...
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| Veröffentlicht in: | Archives of surgery (Chicago. 1960) 2005-11, Vol.140 (11), p.1122-1125 |
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| container_title | Archives of surgery (Chicago. 1960) |
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| creator | Malinoski, Darren J Todd, Samuel R Slone, D. Sue Mullins, Richard J Schreiber, Martin A |
| description | HYPOTHESIS Central venous blood gas (VBG) measurements of pH, PCO2, and base excess can be substituted for the same values obtained from an arterial blood gas (ABG) analysis in mechanically ventilated trauma patients, obviating the need for arterial puncture. DESIGN AND SETTING Prospective comparison of 99 sets of VBGs and ABGs at a level 1 academic trauma center. PATIENTS A consecutive sample of 25 trauma patients admitted to the intensive care unit who required mechanical ventilation and had both central venous and arterial catheters. MAIN OUTCOME MEASURES Pearson correlations and Bland-Altman limits of agreement (LOAs) for pH, PCO2, and base excess values from each set of VBGs and ABGs. RESULTS When VBG and ABG values were compared, pH had R = 0.92, P |
| doi_str_mv | 10.1001/archsurg.140.11.1122 |
| format | Article |
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Sue ; Mullins, Richard J ; Schreiber, Martin A</creator><creatorcontrib>Malinoski, Darren J ; Todd, Samuel R ; Slone, D. Sue ; Mullins, Richard J ; Schreiber, Martin A</creatorcontrib><description>HYPOTHESIS Central venous blood gas (VBG) measurements of pH, PCO2, and base excess can be substituted for the same values obtained from an arterial blood gas (ABG) analysis in mechanically ventilated trauma patients, obviating the need for arterial puncture. DESIGN AND SETTING Prospective comparison of 99 sets of VBGs and ABGs at a level 1 academic trauma center. PATIENTS A consecutive sample of 25 trauma patients admitted to the intensive care unit who required mechanical ventilation and had both central venous and arterial catheters. MAIN OUTCOME MEASURES Pearson correlations and Bland-Altman limits of agreement (LOAs) for pH, PCO2, and base excess values from each set of VBGs and ABGs. RESULTS When VBG and ABG values were compared, pH had R = 0.92, P<.001, and 95% LOAs of −0.09 to 0.03; PCO2, R = 0.88, P<.001, and 95% LOAs of −2.2 to 10.9; and base excess, R = 0.96, P<.001, and 95% LOAs of −2.2 to 1.8. A receiver operating characteristic curve showed that a central venous PCO2 of 50 mm Hg had 100% sensitivity and 84% specificity for determining significant hypercarbia (arterial PCO2 > 50 mm Hg). CONCLUSIONS Central venous and arterial PCO2, pH, and base excess values correlate well, but their LOAs represent clinically significant ranges that could affect management. Although VBGs cannot be substituted for ABGs in mechanically ventilated trauma patients during the initial phases of resuscitation, clinically reliable conclusions can be reached with VBG analysis.Arch Surg. 2005;140:1122-1125--></description><identifier>ISSN: 0004-0010</identifier><identifier>ISSN: 2168-6254</identifier><identifier>EISSN: 1538-3644</identifier><identifier>EISSN: 2168-6262</identifier><identifier>DOI: 10.1001/archsurg.140.11.1122</identifier><identifier>PMID: 16342377</identifier><identifier>CODEN: ARSUAX</identifier><language>eng</language><publisher>Chicago, IL: American Medical Association</publisher><subject>Biological and medical sciences ; Blood Gas Analysis - methods ; Blood vessels ; Carbon Dioxide - blood ; General aspects ; Humans ; Hydrogen-Ion Concentration ; Medical sciences ; Monitoring, Physiologic ; Patients ; Prospective Studies ; Respiration, Artificial ; ROC Curve ; Safety ; Surgery ; Trauma centers ; Wounds and Injuries - blood</subject><ispartof>Archives of surgery (Chicago. 1960), 2005-11, Vol.140 (11), p.1122-1125</ispartof><rights>2006 INIST-CNRS</rights><rights>Copyright American Medical Association Nov 2005</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-a426t-ba7e19229c8f3adedcb7f3f63cba55c1018a9c92fd9d4edba455eeb6ccfb4b833</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://jamanetwork.com/journals/jamasurgery/articlepdf/10.1001/archsurg.140.11.1122$$EPDF$$P50$$Gama$$H</linktopdf><linktohtml>$$Uhttps://jamanetwork.com/journals/jamasurgery/fullarticle/10.1001/archsurg.140.11.1122$$EHTML$$P50$$Gama$$H</linktohtml><link.rule.ids>64,314,776,780,3327,27901,27902,76231,76234</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=17278453$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16342377$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Malinoski, Darren J</creatorcontrib><creatorcontrib>Todd, Samuel R</creatorcontrib><creatorcontrib>Slone, D. Sue</creatorcontrib><creatorcontrib>Mullins, Richard J</creatorcontrib><creatorcontrib>Schreiber, Martin A</creatorcontrib><title>Correlation of Central Venous and Arterial Blood Gas Measurements in Mechanically Ventilated Trauma Patients</title><title>Archives of surgery (Chicago. 1960)</title><addtitle>Arch Surg</addtitle><description>HYPOTHESIS Central venous blood gas (VBG) measurements of pH, PCO2, and base excess can be substituted for the same values obtained from an arterial blood gas (ABG) analysis in mechanically ventilated trauma patients, obviating the need for arterial puncture. DESIGN AND SETTING Prospective comparison of 99 sets of VBGs and ABGs at a level 1 academic trauma center. PATIENTS A consecutive sample of 25 trauma patients admitted to the intensive care unit who required mechanical ventilation and had both central venous and arterial catheters. MAIN OUTCOME MEASURES Pearson correlations and Bland-Altman limits of agreement (LOAs) for pH, PCO2, and base excess values from each set of VBGs and ABGs. RESULTS When VBG and ABG values were compared, pH had R = 0.92, P<.001, and 95% LOAs of −0.09 to 0.03; PCO2, R = 0.88, P<.001, and 95% LOAs of −2.2 to 10.9; and base excess, R = 0.96, P<.001, and 95% LOAs of −2.2 to 1.8. A receiver operating characteristic curve showed that a central venous PCO2 of 50 mm Hg had 100% sensitivity and 84% specificity for determining significant hypercarbia (arterial PCO2 > 50 mm Hg). CONCLUSIONS Central venous and arterial PCO2, pH, and base excess values correlate well, but their LOAs represent clinically significant ranges that could affect management. Although VBGs cannot be substituted for ABGs in mechanically ventilated trauma patients during the initial phases of resuscitation, clinically reliable conclusions can be reached with VBG analysis.Arch Surg. 2005;140:1122-1125--></description><subject>Biological and medical sciences</subject><subject>Blood Gas Analysis - methods</subject><subject>Blood vessels</subject><subject>Carbon Dioxide - blood</subject><subject>General aspects</subject><subject>Humans</subject><subject>Hydrogen-Ion Concentration</subject><subject>Medical sciences</subject><subject>Monitoring, Physiologic</subject><subject>Patients</subject><subject>Prospective Studies</subject><subject>Respiration, Artificial</subject><subject>ROC Curve</subject><subject>Safety</subject><subject>Surgery</subject><subject>Trauma centers</subject><subject>Wounds and Injuries - blood</subject><issn>0004-0010</issn><issn>2168-6254</issn><issn>1538-3644</issn><issn>2168-6262</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkV1rFTEQhoMo9rT6AwSRINS7rfncj8t60CpU9KJ6G2aTid2STWqye9F_b5ZztCAEkpk8804yLyGvObvgjPH3kO1tWfOvC65qhtclxBOy41r2jWyVekp2jDHVVJadkNNS7upJ9IN4Tk54K5WQXbcjYZ9yxgDLlCJNnu4xLhkC_YkxrYVCdPQyL5inmvsQUnL0Cgr9ilBb41zhQqdYY3sLcbIQwsNWukxVER29ybDOQL9X-Q19QZ55CAVfHvcz8uPTx5v95-b629WX_eV1A0q0SzNCh3wQYrC9l-DQ2bHz0rfSjqC15Yz3MNhBeDc4hW4EpTXi2FrrRzX2Up6Rdwfd-5x-r1gWM0_FYggQsf7KtH3fMd2pCr79D7xLa471bUZIobViw6amDpDNqZSM3tznaYb8YDgzmxXmrxWmWmE4N5sVtezNUXsdZ3SPRcfZV-D8CECpk_MZop3KI9eJrld66__qwMEM_241G7jk8g88754n</recordid><startdate>20051101</startdate><enddate>20051101</enddate><creator>Malinoski, Darren J</creator><creator>Todd, Samuel R</creator><creator>Slone, D. Sue</creator><creator>Mullins, Richard J</creator><creator>Schreiber, Martin A</creator><general>American Medical Association</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>20051101</creationdate><title>Correlation of Central Venous and Arterial Blood Gas Measurements in Mechanically Ventilated Trauma Patients</title><author>Malinoski, Darren J ; Todd, Samuel R ; Slone, D. Sue ; Mullins, Richard J ; Schreiber, Martin A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-a426t-ba7e19229c8f3adedcb7f3f63cba55c1018a9c92fd9d4edba455eeb6ccfb4b833</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Biological and medical sciences</topic><topic>Blood Gas Analysis - methods</topic><topic>Blood vessels</topic><topic>Carbon Dioxide - blood</topic><topic>General aspects</topic><topic>Humans</topic><topic>Hydrogen-Ion Concentration</topic><topic>Medical sciences</topic><topic>Monitoring, Physiologic</topic><topic>Patients</topic><topic>Prospective Studies</topic><topic>Respiration, Artificial</topic><topic>ROC Curve</topic><topic>Safety</topic><topic>Surgery</topic><topic>Trauma centers</topic><topic>Wounds and Injuries - blood</topic><toplevel>online_resources</toplevel><creatorcontrib>Malinoski, Darren J</creatorcontrib><creatorcontrib>Todd, Samuel R</creatorcontrib><creatorcontrib>Slone, D. Sue</creatorcontrib><creatorcontrib>Mullins, Richard J</creatorcontrib><creatorcontrib>Schreiber, Martin A</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of surgery (Chicago. 1960)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Malinoski, Darren J</au><au>Todd, Samuel R</au><au>Slone, D. Sue</au><au>Mullins, Richard J</au><au>Schreiber, Martin A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Correlation of Central Venous and Arterial Blood Gas Measurements in Mechanically Ventilated Trauma Patients</atitle><jtitle>Archives of surgery (Chicago. 1960)</jtitle><addtitle>Arch Surg</addtitle><date>2005-11-01</date><risdate>2005</risdate><volume>140</volume><issue>11</issue><spage>1122</spage><epage>1125</epage><pages>1122-1125</pages><issn>0004-0010</issn><issn>2168-6254</issn><eissn>1538-3644</eissn><eissn>2168-6262</eissn><coden>ARSUAX</coden><abstract>HYPOTHESIS Central venous blood gas (VBG) measurements of pH, PCO2, and base excess can be substituted for the same values obtained from an arterial blood gas (ABG) analysis in mechanically ventilated trauma patients, obviating the need for arterial puncture. DESIGN AND SETTING Prospective comparison of 99 sets of VBGs and ABGs at a level 1 academic trauma center. PATIENTS A consecutive sample of 25 trauma patients admitted to the intensive care unit who required mechanical ventilation and had both central venous and arterial catheters. MAIN OUTCOME MEASURES Pearson correlations and Bland-Altman limits of agreement (LOAs) for pH, PCO2, and base excess values from each set of VBGs and ABGs. RESULTS When VBG and ABG values were compared, pH had R = 0.92, P<.001, and 95% LOAs of −0.09 to 0.03; PCO2, R = 0.88, P<.001, and 95% LOAs of −2.2 to 10.9; and base excess, R = 0.96, P<.001, and 95% LOAs of −2.2 to 1.8. A receiver operating characteristic curve showed that a central venous PCO2 of 50 mm Hg had 100% sensitivity and 84% specificity for determining significant hypercarbia (arterial PCO2 > 50 mm Hg). CONCLUSIONS Central venous and arterial PCO2, pH, and base excess values correlate well, but their LOAs represent clinically significant ranges that could affect management. Although VBGs cannot be substituted for ABGs in mechanically ventilated trauma patients during the initial phases of resuscitation, clinically reliable conclusions can be reached with VBG analysis.Arch Surg. 2005;140:1122-1125--></abstract><cop>Chicago, IL</cop><pub>American Medical Association</pub><pmid>16342377</pmid><doi>10.1001/archsurg.140.11.1122</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Biological and medical sciences Blood Gas Analysis - methods Blood vessels Carbon Dioxide - blood General aspects Humans Hydrogen-Ion Concentration Medical sciences Monitoring, Physiologic Patients Prospective Studies Respiration, Artificial ROC Curve Safety Surgery Trauma centers Wounds and Injuries - blood |
| title | Correlation of Central Venous and Arterial Blood Gas Measurements in Mechanically Ventilated Trauma Patients |
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