Mathematical Arterialization of Capillary Blood for Blood Gas Analysis in Critically Ill Patients

Author:

Daher AyhamORCID,Veelken Julia MariaORCID,Müller TobiasORCID

Abstract

<b><i>Background:</i></b> In clinical practice, capillary blood taken from hyperemized earlobes (CBG<sub>E</sub>) or fingertips (CBG<sub>F</sub>) is frequently used as substitute for arterial blood (ABG) for blood gas analysis. While there is a close agreement between ABG and CBG<sub>E</sub>/CBG<sub>F</sub> regarding pH and pCO<sub>2</sub>, pO<sub>2</sub> is often underestimated by CBG. Recently, a software tool (v-TAC<sup>®</sup>; Roche Diagnostics, Risch-Rotkreuz, Switzerland) has been developed to calculate ABG values based on a peripheral venous blood gas analysis supplemented with peripheral oxygen saturation. <b><i>Objective:</i></b> Here we investigate whether v-TAC can also be used to calculate ABG values from capillary blood samples. <b><i>Methods:</i></b> Patients (<i>n</i> = 85) with an indwelling arterial line were included in the study. A reference ABG sample (ABG<sub>1</sub>) was obtained, followed by CBG<sub>E</sub>, CBG<sub>F</sub>, and finally a second ABG (ABG<sub>2</sub>). Results of CBG<sub>E</sub>/CBG<sub>F</sub> before and after mathematical arterialization by v-TAC (aCBG<sub>E</sub>/aCBG<sub>F</sub>) were compared to ABG<sub>1</sub>. <b><i>Results:</i></b> After mathematical arterialization by v-TAC, the mean bias in pO<sub>2</sub> between ABG<sub>1</sub> and CBG<sub>E</sub> went down from 5.24 mm Hg (95% limit of agreement [95% LoA]: −14.19 to 24.67) to 0.18 mm Hg (95% LoA: −11.84 to 12.20) and was in a similar range as the mean bias between ABG<sub>1</sub> and ABG<sub>2</sub> (0.39 mm Hg [95% LoA: −13.46 to 14.24]). Differences in pH and pCO<sub>2</sub> between arterial and capillary samples were small before and after mathematical arterialization. Very similar results were obtained when using fingertip instead of earlobe capillary blood. <b><i>Conclusion:</i></b> In summary, v-TAC can be used for mathematical arterialization of capillary blood samples for blood gas analysis resulting in increased diagnostic accuracy for pO<sub>2</sub>.

Publisher

S. Karger AG

Subject

Pulmonary and Respiratory Medicine

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