Agreement Between Venous and Arterial Blood Gas Measurements in the Intensive Care Unit (AVANTI)

The purpose of this study is to examine the agreement between venous blood gas and arterial blood gas measurements in patients in the Intensive Care Unit.

Study Overview

• Status: Completed
• Conditions: Acid-Base Balance
• Intervention / Treatment: Procedure: Venous blood gas analysis

Detailed Description

Venous blood gas analysis may be an alternative to arterial blood gas analysis for acid-base status, reducing the need for frequent invasive arterial sampling. The objective of this study is to examine the agreement between ABG and VBG samples for all commonly used parameters (pH, pCO2 and bicarbonate) in a pathologically diverse ICU patient population, specifically analyzing multiple paired arterial and venous samples from each patient.

• Study Type: Interventional
• Enrollment (Actual): 40
• Phase: Not Applicable

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 14 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Adult patients 18 years or older
• Admitted to the Intensive Care Unit (ICU)
• Determined by their treating clinicians to require both a central venous line and arterial line

Exclusion Criteria:

• None

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Diagnostic
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Other: 1	Procedure: Venous blood gas analysis; When an ABG is deemed to be necessary as part of ICU management, a central venous sample will also be obtained with minimum delay (always < 2 minutes) between the samples. The samples will be analyzed by a blood gas analyzer as quickly as possible.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Agreement between venous and arterial blood gas measurements of pH, pCO2 and bicarbonate	Duration of Intensive Care Unit Admission

Collaborators and Investigators

• Sponsor: Olive View-UCLA Education & Research Institute
• Investigators: Principal Investigator: Richard M Treger, M.D., Olive View-UCLA Education & Research Institute

Publications and helpful links

General Publications

• Ak A, Ogun CO, Bayir A, Kayis SA, Koylu R. Prediction of arterial blood gas values from venous blood gas values in patients with acute exacerbation of chronic obstructive pulmonary disease. Tohoku J Exp Med. 2006 Dec;210(4):285-90. doi: 10.1620/tjem.210.285.
• Kelly AM, McAlpine R, Kyle E. Venous pH can safely replace arterial pH in the initial evaluation of patients in the emergency department. Emerg Med J. 2001 Sep;18(5):340-2. doi: 10.1136/emj.18.5.340.
• Mortensen JD. Clinical sequelae from arterial needle puncture, cannulation, and incision. Circulation. 1967 Jun;35(6):1118-23. doi: 10.1161/01.cir.35.6.1118. No abstract available.
• Criscuolo C, Nepper G, Buchalter S. Reflex sympathetic dystrophy following arterial blood gas sampling in the intensive care setting. Chest. 1995 Aug;108(2):578-80. doi: 10.1378/chest.108.2.578.
• Malinoski DJ, Todd SR, Slone S, Mullins RJ, Schreiber MA. Correlation of central venous and arterial blood gas measurements in mechanically ventilated trauma patients. Arch Surg. 2005 Nov;140(11):1122-5. doi: 10.1001/archsurg.140.11.1122.
• Kelly AM, Kyle E, McAlpine R. Venous pCO(2) and pH can be used to screen for significant hypercarbia in emergency patients with acute respiratory disease. J Emerg Med. 2002 Jan;22(1):15-9. doi: 10.1016/s0736-4679(01)00431-0.
• Rang LC, Murray HE, Wells GA, Macgougan CK. Can peripheral venous blood gases replace arterial blood gases in emergency department patients? CJEM. 2002 Jan;4(1):7-15. doi: 10.1017/s1481803500006011.
• Kelly AM, McAlpine R, Kyle E. Agreement between bicarbonate measured on arterial and venous blood gases. Emerg Med Australas. 2004 Oct-Dec;16(5-6):407-9. doi: 10.1111/j.1742-6723.2004.00642.x.
• Ma OJ, Rush MD, Godfrey MM, Gaddis G. Arterial blood gas results rarely influence emergency physician management of patients with suspected diabetic ketoacidosis. Acad Emerg Med. 2003 Aug;10(8):836-41. doi: 10.1111/j.1553-2712.2003.tb00625.x.
• Gokel Y, Paydas S, Koseoglu Z, Alparslan N, Seydaoglu G. Comparison of blood gas and acid-base measurements in arterial and venous blood samples in patients with uremic acidosis and diabetic ketoacidosis in the emergency room. Am J Nephrol. 2000 Jul-Aug;20(4):319-23. doi: 10.1159/000013607.
• Middleton P, Kelly AM, Brown J, Robertson M. Agreement between arterial and central venous values for pH, bicarbonate, base excess, and lactate. Emerg Med J. 2006 Aug;23(8):622-4. doi: 10.1136/emj.2006.035915.
• Chu YC, Chen CZ, Lee CH, Chen CW, Chang HY, Hsiue TR. Prediction of arterial blood gas values from venous blood gas values in patients with acute respiratory failure receiving mechanical ventilation. J Formos Med Assoc. 2003 Aug;102(8):539-43.
• Brandenburg MA, Dire DJ. Comparison of arterial and venous blood gas values in the initial emergency department evaluation of patients with diabetic ketoacidosis. Ann Emerg Med. 1998 Apr;31(4):459-65. doi: 10.1016/s0196-0644(98)70254-9.
• Malatesha G, Singh NK, Bharija A, Rehani B, Goel A. Comparison of arterial and venous pH, bicarbonate, PCO2 and PO2 in initial emergency department assessment. Emerg Med J. 2007 Aug;24(8):569-71. doi: 10.1136/emj.2007.046979.

Study record dates

Study Major Dates

• Study Start: January 1, 2008
• Primary Completion (Actual): July 1, 2008
• Study Completion (Actual): July 1, 2008

Study Registration Dates

• First Submitted: December 6, 2007
• First Submitted That Met QC Criteria: December 6, 2007
• First Posted (Estimate): December 7, 2007

Study Record Updates

• Last Update Posted (Actual): March 15, 2021
• Last Update Submitted That Met QC Criteria: March 10, 2021
• Last Verified: March 1, 2021

More Information

Terms related to this study

• Keywords: Arterial blood gas; pH; Bicarbonate; Venous blood gas; pCO2
• Other Study ID Numbers: 07H-821001