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- Ekström, Magnus, et al.
(author)
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Calculated arterial blood gas values from a venous sample and pulse oximetry : Clinical validation
- 2019
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In: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 14:4
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Journal article (peer-reviewed)abstract
- Background Arterial blood gases (ABG) are essential for assessment of patients with severe illness, but sampling is difficult in some settings and more painful than for peripheral venous blood gas (VBG). Venous to Arterial Conversion (v-TAC; OBIMedical ApS, Denmark) is a method to calculate ABG values from a VBG and pulse oximetry (SpO 2 ). The aim was to validate v-TAC against ABG for measuring pH, carbon dioxide (pCO 2 ) and oxygenation (pO 2 ). Methods Of 103 sample sets, 87 paired ABGs and VBGs with SpO 2 from 46 inpatients eligible for ABG met strict sampling criteria. Agreement was evaluated using mean difference with 95% limits of agreement (LoA) and Bland-Altman plots. Results v-TAC had very high agreement with ABG for pH (mean diff (ABG–v-TAC) -0.001; 95% LoA -0.017 to 0.016), pCO 2 (-0.14 kPa; 95% LoA -0.46 to 0.19) and moderate to high for pO 2 (-0.28 kPa; 95% LoA -1.31 to 0.76). For detecting hypercapnia (PaCO 2 >6.0 kPa), v-TAC had sensitivity 100%, specificity 93.8% and accuracy 97%. The accuracy of v-TAC for detecting hypoxemia (PaO 2 <8.0 kPa) was comparable to that of pulse oximetry. Agreement with ABG was higher for v-TAC than for VBG for all analyses. Conclusion Calculated arterial blood gases (v-TAC) from a venous sample and pulse oximetry were comparable to ABG values and may be useful for evaluation of blood gases in clinical settings. This could reduce the logistic burden of arterial sampling, facilitate improved screening and follow-up and reduce patient pain.
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| 2. |
- Odeberg, Jacob, et al.
(author)
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The influence of smoking and impaired glucose homoeostasis on the outcome in patients presenting with an acute coronary syndrome : a cross-sectional study
- 2014
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In: BMJ Open. - : BMJ. - 2044-6055. ; 4:7, s. e005077-
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Journal article (peer-reviewed)abstract
- Objectives: Smoking, diabetes, male sex, hypercholesterolaemia and hypertension are well-established risk factors for the development of coronary artery disease (CAD). However, less is known about their role in influencing the outcome in the event of an acute coronary syndrome (ACS). The aim of this study was to determine if these risk factors are associated specifically with acute myocardial infarction (MI) or unstable angina (UA) in patients with suspected ACS. Design: Cross-sectional study. Setting: Patients admitted to the coronary care unit, via the emergency room, at a central county hospital over a 4-year period (1992-1996). Participants: From 5292 patients admitted to the coronary care unit, 908 patients aged 30-74 years were selected, who at discharge had received the diagnosis of either MI (527) or UA (381). A control group consisted of 948 patients aged 30-74 years in whom a diagnosis of ACS was excluded. Main outcome measures: MI or UA. Results: Current smoking (OR 2.42 (1.61 to 3.62)), impaired glucose homoeostasis defined as glycated haemoglobin >= 5.5% + blood glucose >= 7.5 mM (OR 1.78 (1.19 to 2.67)) and male sex (OR 1.71 (1.21 to 2.40)) were significant factors predisposing to MI over UA, in the event of an ACS. Compared with the non-ACS group, impaired glucose homoeostasis, male sex, cholesterol level and age were significantly associated with development of an ACS (MI and UA). Interestingly, smoking was significantly associated with MI (OR 2.00 (1.32 to 3.02)), but not UA. Conclusions: Smoking or impaired glucose homoeostasis is an acquired risk factor for a severe ACS outcome in patients with CAD. Importantly, smoking was not associated with UA, suggesting that it is not a risk factor for all clinical manifestations of CAD, but its influence is important mainly in the acute stages of ACS. Thus, on a diagnosis of CAD, the cessation of smoking and management of glucose homoeostasis are of upmost importance to avoid severe subsequent ACS consequences.
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