You are seeing this message because your Web browser does not support basic Web standards. Find out more about why this message is appearing and what you can do to make your experience on this site better.


ABOUT ARCHIVES
Advanced Search

Welcome   | My Account | E-mail Alerts | Access Rights | Sign In


  Vol. 140 No. 11, November 2005 TABLE OF CONTENTS
  Archives
  •  Online Features
  Poster Session
 This Article
 •Full text
 •PDF
 •Send to a friend
 • Save in My Folder
 •Save to citation manager
 •Permissions
 Citing Articles
 •Citation map
 •Citing articles on HighWire
 •Citing articles on ISI (4)
 •Contact me when this article is cited
 Related Content
 •Related letters
 •Similar articles in this journal
 Topic Collections
 •Critical Care/ Intensive Care Medicine
 •Adult Critical Care
 •Surgical Interventions, Other
 •Emergency Medicine
 •Alert me on articles by topic
 Social Bookmarking
  Add to CiteULike Add to Connotea Add to Del.icio.us Add to Digg Add to Reddit Add to Technorati
What's this?

Correlation of Central Venous and Arterial Blood Gas Measurements in Mechanically Ventilated Trauma Patients

Darren J. Malinoski, MD; Samuel R. Todd, MD; D. Sue Slone, MD; Richard J. Mullins, MD; Martin A. Schreiber, MD

Arch Surg. 2005;140:1122-1125.

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.


Author Affiliations: Departments of Surgery, Oregon Health and Science University, Portland (Drs Malinoski, Mullins, and Schreiber), The University of Texas Health Science Center, Houston (Dr Todd), and Swedish Medical Center, Denver, Colo (Dr Slone). Dr Malinoski is now with the Division of Trauma Surgery & Critical Care, Los Angeles County + University of Southern California Medical Center, Los Angeles.



Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati     What's this?

RELATED LETTERS

Venous Blood Oxygen Saturation
Brandon Wills
Arch Surg. 2006;141(7):716.
EXTRACT | FULL TEXT  

Venous Blood Oxygen Saturation—Reply
Darren J. Malinoski, Richard J. Mullins, and Martin A. Schreiber
Arch Surg. 2006;141(7):716.
EXTRACT | FULL TEXT  


THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Comparison of arterial and venous pH, bicarbonate, PCO2 and PO2 in initial emergency department assessment
Malatesha et al.
Emerg. Med. J. 2007;24:569-571.
ABSTRACT | FULL TEXT  

Agreement between arterial and central venous values for pH, bicarbonate, base excess, and lactate.
Middleton et al.
Emerg. Med. J. 2006;23:622-624.
ABSTRACT | FULL TEXT  

Venous Blood Oxygen Saturation
Wills
Arch Surg 2006;141:716-716.
FULL TEXT  

Venous Blood Oxygen Saturation--Reply
Malinoski et al.
Arch Surg 2006;141:716-716.
FULL TEXT  





HOME | CURRENT ISSUE | PAST ISSUES | TOPIC COLLECTIONS | CME | SUBMIT | SUBSCRIBE | HELP
CONDITIONS OF USE | PRIVACY POLICY | CONTACT US | SITE MAP
 
© 2005 American Medical Association. All Rights Reserved.