Ma. Brandenburg et Dj. Dire, COMPARISON OF ARTERIAL AND VENOUS-BLOOD GAS VALUES IN THE INITIAL EMERGENCY DEPARTMENT EVALUATION OF PATIENTS WITH DIABETIC-KETOACIDOSIS, Annals of emergency medicine, 31(4), 1998, pp. 459-465
Study objective: To determine whether venous blood gas values can repl
ace arterial gas Values in the initial emergency department evaluation
of patients with suspected diabetic ketoacidosis. Methods: This prosp
ective comparison was performed in an adult university teaching hospit
al ED. Samples for arterial and venous blood gas analysis were obtaine
d during initial ED evaluations. The venous gas samples were collected
with samples for other blood tests at the time of intravenous line in
sertion. Both arterial and venous samples were obtained before the ini
tiation of treatment.Result: Data from 44 episodes of diabetic ketoaci
dosis in 38 patients were analyzed. Laboratory findings of those patie
nts with diabetic ketoacidosis were as follows (mean+/-SD): arterial p
H, 7.20+/-.14; venous pH, 7.17+/-.13; serum glucose, 33.8+/-16 mmol/L
(609+/-288 mg/dL); arterial HCO3-, 11.0+/-6.0 mmol; venous HCO3-, 12.8
+/-5.5 mmol/L; serum CO2, 11.8+/-5.0 mmol/L; and anion gap, 26.7+/-7.6
mmol/L. The mean difference between arterial and venous pH values was
0.03 (range 0.0 to 0.11). Arterial and venous pH results (r=.9689) an
d arterial and venous HCO3- results (r=.9543) were highly correlated a
nd showed a high measure of agreement. Conclusion: Venous blood gas me
asurements accurately demonstrate the degree of acidosis of adult ED p
atients presenting with diabetic ketoacidosis.