Venous pH can safely replace arterial pH in the initial evaluation of patients in the emergency department

Objective-This study aims to determine the extent of correlation of arteria l and venous pH with a view to identifying whether venous samples can be us ed as an alternative to arterial values in the clinical management of selec ted patients in the emergency department. Methods-This prospective study of patients who were deemed by their treatin g doctor to require an arterial blood gas analysis to determine their venti latory or acid-base status, compared pH on an arterial and a venous sample taken as close to simultaneously as possible. Data were analysed using Pear son correlation and bias (Bland-Altman) methods. Results-Two hundred and forty six patients were entered into the study; 196 with acute respiratory disease and 50 with suspected metabolic derangement . The values of pH on arterial and venous samples were highly correlated (r =0.92) with an average difference between the samples of -0.4 units. There was also a high level of agreement between the methods with the 95% limits of agreement being -0.11 to +0.04 units. Conclusion-Venous pH estimation shows a high degree of correlation and agre ement with the arterial value, with acceptably narrow 95% limits of agreeme nt. Venous pH estimation is an acceptable substitute for arterial measureme nt and may reduce risks of complications both for patients and health care workers.