Key result
Venous blood gas sampling is clinically interchangeable with arterial sampling for pH in stable DKA patients, with a weighted average difference of 0.02 pH units (95% limits of agreement -0.009 to 0.021).
Why the study?
Does venous blood gas sampling provide clinically acceptable alternatives to arterial measurements for pH and bicarbonate in patients with diabetic ketoacidosis?
Does venous blood gas sampling provide clinically acceptable alternatives to arterial measurements for pH and bicarbonate in patients with diabetic ketoacidosis?
Mean Difference: 0.02 (95% CI -0.009–0.021)
Venous and arterial pH have sufficient agreement to be clinically interchangeable in hemodynamically stable DKA patients without respiratory failure, potentially reducing the need for painful arterial punctures.
Supports venous pH sampling to reduce arterial punctures in stable DKA; confirms interchangeability via Level 1 evidence.
OBJECTIVES: For patients with diabetic ketoacidosis (DKA), arterial blood gas (BG) sampling for measurement of pH and bicarbonate has been considered an essential part of initial evaluation and monitoring of progress. There is growing evidence that venous values can be clinically acceptable alternatives to arterial measurements. This article summarizes the recent evidence regarding the validity of venous BG sampling in DKA. METHODS: Medline search for the years 1995 to present, hand search of reference lists, search of on-line evidence-based medicine sites. RESULTS: In patients with DKA the weighted average difference between arterial and venous pH was 0.02 pH units (95% limits of agreement -0.009 to +0.021 pH units) and between arterial and venous bicarbonate was -1.88 mEq/L. CONCLUSIONS: There is reasonable evidence that venous and arterial pH have sufficient agreement as to be clinically interchangeable in patients with DKA who are haemodynamically stable and without respiratory failure. There is some evidence that venous and arterial bicarbonate also agree closely in DKA but this requires confirmation.
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Anne‐Maree Kelly (2006) conducted a review in Diabetic ketoacidosis (DKA). Venous blood gas sampling vs. Arterial blood gas sampling was evaluated on Difference between arterial and venous pH (MD 0.02 pH units, 95% CI -0.009 to 0.021). Venous blood gas sampling is clinically interchangeable with arterial sampling for pH in stable DKA patients, with a weighted average difference of 0.02 pH units (95% limits of agreement -0.009 to 0.021).
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