Venous Blood Gas (Vbg) Analyzer
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pH
pCO(2)
HCO(3)
~Anion-Gap Analysis Data (Optional)
Na+ (nl 135-145 mEq-mmol/L)
Cl- (nl 96-108 mEq-mmol/L)
R e s u l t s
~Anion-Gap Analysis Data (Optional)
 
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VBG Analyzer
 
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Venous Blood Gas (Vbg) Analyzer

This information relates to use of venous rather than arterial specimens for blood gases.

The vast majority of patients who currently receive Arterial Blood Gas (ABG) evaluation can reliably have Venous Blood Gas (VBG) analysis. VBG is well studied and correlates well with patients with an acidosis (respiratory or metabolic).

If the clinical question is the degree of acidosis, whether a respiratory or metabolic acidosis exists and the degree thereof; VBG can reliably answer such questions and replace ABG.

Cases where VBG can reliably replace ABG include:

  • To evaluate pH (when normal or acidotic)
  • To evaluate pCO 2
  • To evaluate HCO 3

Cases where VBG cannot reliably replace ABG include:

  • To determine PO 2
  • In cases of alkalosis (metabolic or respiratory)

When VBG is selected, this program will not allow entry of PO 2 (as not reliable) and will not accept a pH over 7.40.

Adjustments will be made as follows:

  • VBG pH will have 0.03 added to it to normalize to Arterial pH
  • VBG pCO 2 with have 6 subtracted from it to normalize to Arterial pCO 2
  • VBG HCO 3 will have 1.6 added to it to normalize to Arterial HCO 3

References:

  • 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;31(4):459-65.
  • Gokel Y, Paydas S, Koseoglu Z, et al. 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;20(4):319-23.
  • Hassan Z, Subramonyam DM, Thakore S. Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. Venous blood gas in adult patients with diabetic ketoacidosis. Emerg Med J. 2003;20(4):363-4.
  • 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;18(5):340-2.
  • Kelly AM, Mcalpine R, Kyle E. Agreement between bicarbonate measured on arterial and venous blood gases. Emerg Med Australas. 2004;16(5-6):407-9.
  • Kelly AM. The case for venous rather than arterial blood gases in diabetic ketoacidosis. Emerg Med Australas. 2006;18(1):64-7.
  • Malatesha G, Singh NK, Bharija A, et al. Comparison of arterial and venous pH, bicarbonate, PCO2 and PO2 in initial emergency department assessment. Emerg Med J. 2007;24(8):569-71.
  • Umeda A, Kawasaki K, Abe T, et al. Hyperventilation and finger exercise increase venous-arterial Pco2 and pH differences. Am J Emerg Med. 2008;26(9):975-80.