Primerljivost parametrov plinske analize arterijske in venske krvi pri življenjsko ogroženem pacientu
sistematični pregled literature
DOI:
https://doi.org/10.14528/snr.2025.59.2.3283Ključne besede:
vzorec arterijske krvi, vzorec venske krvi, podobnost vrednosti parametrov, urgentno stanjePovzetek
Uvod: Oceno metabolnega, kardiovaskularnega in respiratornega stanja pri življenjsko ogroženem odraslem pacientu diagnosticiramo s plinsko analizo arterijske krvi. Ta je mogoča tudi na osnovi venskega vzorca krvi, katerega odvzem je za pacienta manj invaziven. Namen pregleda literature je ugotoviti primerljivost vrednosti parametrov pH, HCO₃, pCO₂, pO₂, Na, K in Cl med plinsko analizo arterijske in venske krvi pri življenjsko ogroženem odraslem pacientu.
Metode: Sistematični pregled literature je potekal v mednarodnih bazah podatkov CINAHL, PubMed, Cohrane Library, Web of Science, Wiley Online Library in iskalniku Google Scholar v obdobju objav med letoma 2014 in 2024. Uporabljen je bil iskalni niz v angleškem jeziku: (life-threatened patient OR critically ill patient) AND (arterial blood gas OR venous blood gas OR VBG OR ABG) AND (compare OR difference). Pri vključenih posameznih kvantitativnih raziskavah je bila ocenjena kakovost, ugotovitve pa so bile povzete opisno.
Rezultati: V končno analizo je bilo vključenih 12 raziskav, ki so bile ocenjene z zmerno in visoko kakovostjo po ocenjevalnih orodjih Joanna Briggs Institute. Pri osmih raziskavah je bila ugotovljena zelo močna primerljivost parametrov pH (r = 0,729–0,979) in HCO₃ (r = 0,7–0,97) med vzorci arterijske in venske krvi. Iz vzorca venske krvi je bila ugotovljena šibka in zmerna primerljivost za parametre pCO2 (r = 0,491–0,95), pO₂ (r = –0,027–0,34), Na (r = 0,652–0,92), K (r = 0,6–0,91) in Cl (r = 0,73–0,94).
Diskusija in zaključek: Ugotovitve raziskav kažejo, da je uporaba vzorca venske krvi primerljiva za analizo parametrov pH in HCO₃. Predlagano je nadaljnje raziskovanje primerljivosti parametrov pCO2, pO₂, Na, K in Cl.
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Literatura
Adhikari, S., Shrestha, S. K., Srivastava, B., KC, N. B., Singh, B. B., & Bhattarai, M. D. (2015). Correlation of arterial blood gas measurement with peripheral venous blood gas values in adults patients admitted in ICU. Journal of Chitwan Medical College, 5(3), 11–17. https://www.nepjol.info/index.php/JCMC/article/view/16520
Ahsan, A. A., Faruq, M. O., Fatema, K., Ahmed, F., Saha, D. K., Saha, M., Nazneen, S., & Sultana, R. (2016). Peripheral venous blood gas analysis: An alternative to arterial blood gas analysis for resuscitation and monitoring of critically ill patients. Bangladesh Critical Care Journal, 4(2), 92–95. https://doi.org/10.3329/bccj.v4i2.30023
Aromataris, E., & Munn, Z. (2020, December 21). JBI manual for evidence synthesis. Johanna Briggs Institute. https://synthesismanual.jbi.global
Ažman, M., & Prestor, J. (ur.). (2021). Poklicne kompetence in aktivnosti izvajalcev v dejavnosti zdravstvene nege z razlago. Zbornica zdravstvene in babiške nege Slovenije- Zveza strokovnih društev medicinskih sester, babic in zdravstvenih tehnikov Slovenije. http://www.zbornica-zveza.si/wp-content/uploads/2021/07/Z-Z_PoklicneKompetence_2021_splet_.pdf
Betts, J. G., Young, K. A., Wise, J. A., Johnson, E., Poe, B., Kruse, H., Korol, O., Johnson, J. E., Womble, M., & DeSaix, P. (2013). Anatomy and physiology. Jordan University of Science and Technology. http://oer.just.edu.jo/xmlui/handle/123456789/280
Bijapur, M. B., Kudligi, N. A., & Asma, S. (2019). Central venous blood gas analysis: An alternative to arterial blood gas analysis for pH, pCO2, bicarbonate, sodium, potassium and chloride in the intensive care unit patients. Indian Journal of Critical Care Medicine, 23(6), 258–262. https://doi.org/10.5005/jp-journals-10071-23176 PMid:31435143; PMCid:PMC6698350
Bloom, B. M., Grundlingh, J., Bestwick, J. P., & Harris, T. (2014). The role of venous blood gas in the emergency department: A systematic review and meta-analysis. European Journal of Emergency Medicine, 21(2), 81–88. https://doi.org/10.1097/mej.0b013e32836437cf PMid:23903783
Chong, W. H., Saha, B. K., & Medarov, B. I. (2021). Comparing central venous blood gas to arterial blood gas and determining its utility in critically ill patients: Narrative review. Critical Care and Resuscitation, 133(2), 374–378. https://doi.org/10.1213/ane.0000000000005501 PMid:33780397
Chung, P. A., Scavone, A., Ahmed, A., Kuchta, K., & Bellam, S. K. (2019). Agreement and correlation of arterial and venous blood Gas analysis in a diverse population. Clinical Medicine Insights: Trauma and Intensive Medicine, 10, Article 1179560319845869. https://doi.org/10.1177/1179560319845869
Dancey, C., & Reidym J. (2017). Statistics without paths for psychology (7th ed.). Pearson.
Davison, L., McSporran, W., Brady, G., Forsythe, C., & Ratcliffe, O. (2021). Respiratory care, CRP and blood transfusion. In S. Lister, J. Hofland, H. Grafton & C. Wilson, (Eds.), The Royal Marsden Manual of Clinical Nursing Procedures (10th ed., pp. 539–655). Wiley Blackwell.
Dimech, A., Fernandes, A., Gronthoud, F., Li, L., & Witt, B. (2021). Diagnostic test. In S. Lister, J. Hofland, H. Grafton & C. Wilson, (Eds.), The Royal Marsden Manual of Clinical Nursing Procedures (10th ed., pp. 659–717). Wiley Blackwell.
Gappa, M., & Beydon, N. (2021). Applied respiratory physiology. In E. Eber & F. Midulla, (Eds.), ERS Handbook of Pediatric respiratory medicine (2nd ed., pp. 14–23). European Respiratory Society.
Gupta, A., Jain, H., Rehman, A. U., & Choubey, P. (2016). Comparison of arterial and venous blood gas measurements in non-respiratory diseases patients admitted in intensive care unit (ICU). Scholars Journal of Applied Medical Sciences, 4(6), 1913–1918. https://doi.org/10.36347/sjams.2016.v04i06.009
Haneef, S., Jaffer, R., Ijaz, A., Ain, Q., Aman, S., & Ansari, U. (2022). Correlation of mean pH, HCO3 and CO2 between arterial blood gases and venous blood gases in critically ill patients. Pakistan Armed Forces Medical Journal, 72(5), 1526–1530. https://doi.org/10.51253/pafmj.v72i5.3156
Hasan, A. (2013). The analysis of blood gases. In A. Hasen, (Ed.), Handbook of Blood Gas/Acid-Base Interpretation (pp. 253–266). Springer.
Kelly, A.-M. (2016). Can VBG analysis replace ABG analysis in emergency care? Emergency Medicine Journal, 33(2), 152–154. https://doi.org/10.1136/emermed-2014-204326 PMid:25552544
Kešpert, B. (2013). Hitre krvne in druge preiskave na terenu in v urgentni ambulanti. In I. Crnić (Ed.), Prepoznavanje in ustrezno ukrepanje ob življenjsko ogroženem pacientu: zbornik predavanj z recenzijo. Strokovni seminar, Portorož 19. in 20. april 2013 (pp. 71–81). Zbornica zdravstvene in babiške nege - Zveza strokovnih društev medicinskih sester, babic in zdravstvenih tehnikov Slovenije, Sekcija reševacev v zdravstvu. https://www.zbornica-zveza.si/wp-content/uploads/2021/03/Prepoznavanje-in-ustrezno-ukrepanje-ob-ogroženemupacientu-2013.pdf
Kmet, M., 2017. Pasti plinske analize arterijske krvi. In R. Vajd & M. Gričar, (Eds.), Urgentna medicina izbrana poglavja. 24. mednarodni simpozij o urgentni medicini. Portorož 15.–17. junij 2017 (pp. 99–101). Slovensko združenje za urgentno medicino. https://repository.ukim.mk/bitstream/20.500.12188/21646/1/Simpozij_zbornik_2017.pdf#page=101
McKeever, T. M., Hearson, G., Housley, G., Reynolds, C., Kinnear, W., Harrison, T. W., Kelly, A. M., & Shaw, D. E. (2016). Using venous blood gas analysis in the assessment of of COPD exacerbations: A prospective cohort study. Thorax, 71(3), 210–215. https://doi.org/10.1136/thoraxjnl-2015-207573 PMid:26628461; PMCid:PMC4789825
Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing and healthcare: A guide to best practice. Wolters Kluwer.
Najeeb, R., Yadav, N., Asma, A., Ommid, M., Bashir, F., Hameem, A., Jehan, N., & Ahmad, M. (2015). Comparative evaluation of central venous versus arterial blood sample for repetitive measurements in critically ill patients admitted in intensive care unit. Journal of Evolution of Medical and Dental Sciences, 4(65), 11375–11386. https://doi.org/10.14260/jemds/2015/1640
Nanjayya, Y. B., McCracken, P., Vallance, S., Board, J., Kelly, P. J., Schneider, H. G., Pilcher, D., & Garner, D. J. (2020). Arterio-venous intra subject agreement for blood gases within intensive care: The avensis study. Journal of the Intensive Care Society, 21(1), 64–71. https://doi.org/10.1177/1751143719840259 PMid:32284720; PMCid:PMC7137164
Naz, S., Chugh, K., & Malik, I. (2019). Can venous blood gas be a reliable substitute for arterial blood gas in modern clinical practice? International Journal of Advances in Medicine, (6)4, 1021–2026. https://doi.org/10.18203/2349-3933.ijam20193252
Nusrullah, M., Younus, M., & Nasir, Y. (2018). Relationship between arterial and venous blood gases in patients presenting with chronic obstructive pulmonary disease. Annals of King Edward Medical University, 24(1), 119–123. https://doi.org/10.21649/akemu.v24i1.2343
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., McGuinness, L. A., ... Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ, 372, Article n71. https://doi.org/10.1136/bmj.n71 PMid:33782057; PMCid:PMC8005924
Prasad, H., Vempalli, N., Agrawal, N., Ajun, U. N., Salam, A., Subhra Datta, S., Singhal, A., Ranjan, N., Sherin, P. P. S., & Sundareshan, G. (2023). Correlation and agreement between arterial and venous blood gas analysis in patients with hypotension: An emergency department based cross sectional study. International Journal of Emergency Medicine, 16(18), Article 18. https://doi.org/10.1186/s12245-023-00486-0 PMid:36899297; PMCid:PMC9999648
Ress, K. L., Koerbin, G., Li, L., Chesher, D., Bwititi, P., & Horvath, A. R. (2021). Reference intervals for venous blood gas measurement in adults. Clinical Chemistry and Laboratory Medicine, 59(5), 947–954. https://doi.org/10.1515/cclm-2020-1224 PMid:33554517
Schrauben, S. J., Negoianu, D., Costa, C., Cohen, R., Goldfarb, S., Fuchs, B., & Berns, J. (2018). Accuracy of acid-base diagnoses using the central venous blood gas in the medical intensive care unit. Nephron, 139(4), 293–298. https://doi.org/10.1159/000488501 PMid:29649820; PMCid:PMC6067967
Schütz, N., Roth, D., Schwameis, M., Röggla, M., & Domanovits, H. (2019). Can venous blood gas be used as an alternative to arterial blood gas in intubated patients at admission to the emergency department: A retrospective study. Open Access Emergency Medicine, 11, 305–312. https://doi.org/10.2147/oaem.s228420 PMid:31920407; PMCid:PMC6934126
Snoj, N., & Prah Krumpak, M. (2021). Priporočila za venski odvzem krvi (2nd ed.). Slovensko združenje za klinično kemijo in laboratorijsko medicino. https://www.szkklm.si/assets/images/upload/PP_1_II__07_WEB.pdf
Teixeira, S. M. A., Coelho, J. C. F., Sequeira, C. A. C., Lluch, I., Canut, M. T., & Ferré-Grau, C. (2019). The effectiveness of positive mental health programs in adults: A systematic review. Health & Social Care in the Community, 27(5), 1126–1134. https://doi.org/10.1111/hsc.12776 PMid:31144395
Thangaraj, R. K., Chidambaram, H. H. S., Dominic, M., Chandrasekaran, V. P., Padmanabhan, K. N., & Chanjal, K. S. (2021). A comparison of arterial and venous blood gas analysis and its interpretation in emergency department: A cross-sectional study. Eurasian Journal of Emergency Medicine, 20(3), 178–182. http://doi.org/10.4274/eajem.galenos.2021.85520
Urbas, U. (2017). Obravnava pacienta z bolečino v trebuhu v urgentni kirurški ambulanti. In R. Vajd & M. Gričar (Eds.), Urgentna medicina izbirna poglavja. 24. mednarodni simpozij o urgentni medicini. Portorož, 15. – 17. junij 2017 (pp. 328–332). Slovensko združenje za urgentno medicino. https://www.szum.si/media/uploads/files/Simpozij_zbornik_2017.pdf#page=329
Wilcox, S. R., Aydin, A., & Marcolini, E. G. (2022). Blood gas analysis. In S. R. Wilcox, A. Aydin & E. G. Marcolini (Eds.), Mechanical Ventilation in Emergency Medicine (2nd ed., pp. 27–29). Springer.
White, H. D., Vazquez-Sandoval, A., Quiroga, P. F., Song, J., Jones, S. F., & Arroliga, A. C. (2018). Utility of venous blood gases in severe sepsis and septic shock. Baylor University Medical Center Proceedings, 31(3), 269–275. https://doi.org/10.1080%2F08998280.2018.1460133 PMid:29904286; PMCid:PMC5997042
Zeserson, E., Goodgame, B., Hess, J. D., Schultz, K., Hoon, C., Lamb, K., Maheshwari, V., Johnson, S., Papas, M., Reed, J., & Breyer, M. (2018). Correlation of venous blood gas and pulse oximetry with arterial blood gas in the undifferentiated critically Ill patient. Journal of Intensive Care Medicine, 33(3), 176–181. https://doi.org/10.1177/0885066616652597 PMid:27283009; PMCid:PMC5885755
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