A pilot assessment of alpha-stat vs pH-stat arterial blood gas analysis after cardiac arrest
Copyright © 2014 Elsevier Inc. All rights reserved..
PURPOSE: Resuscitated cardiac arrest (CA) patients typically receive therapeutic hypothermia, but arterial blood gases (ABGs) are often assessed after adjustment to 37°C (alpha-stat) instead of actual body temperature (pH-stat). We sought to compare alpha-stat and pH-stat assessment of PaO2 and PaCO2 in such patients.
MATERIALS AND METHODS: Using ABG data obtained during the first 24 hours of intensive care unit admission, we determined the impact of measured alpha vs calculated pH-stat on PaO2 and PaCO2 on patient classification and outcomes for CA patients.
RESULTS: We assessed 1013 ABGs from 120 CA patients with a median age of patients 66 years (interquartile range, 50-76). Median alpha-stat PaO2 changed from 122 (95-156) to 107 (82-143) mm Hg with pH-stat and median PaCO2 from 39 (34-46) to 35 (30-41) mm Hg (both P < .001). Using the categories of hyperoxemia, normoxemia, and hypoxemia, pH-stat estimation of PaO2 reclassified approximately 20% of patients. Using the categories of hypercapnia, normocapnia, and hypocapnia, pH stat estimation of PaCO2 reclassified approximately 40% of patients. The mortality of patients in different PaO2 and PaCO2 categories was similar for pH-stat and alpha-stat.
CONCLUSIONS: Using the pH-stat method, fewer resuscitated CA patients admitted to intensive care unit were classified as hyperoxemic or hypercapnic compared with alpha-stat. These findings suggest an impact of ABG assessment methodology on PaO2, PaCO2 , and patient classification but not on associated outcomes.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2015 |
|---|---|
| Erschienen: |
2015 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:30 |
|---|---|
| Enthalten in: |
Journal of critical care - 30(2015), 1 vom: 15. Feb., Seite 138-44 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Eastwood, Glenn M [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Arterial blood gas |
|---|
| Anmerkungen: |
Date Completed 16.03.2015 Date Revised 02.12.2018 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1016/j.jcrc.2014.09.022 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM24404466X |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM24404466X | ||
| 003 | DE-627 | ||
| 005 | 20231224133836.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231224s2015 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.jcrc.2014.09.022 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n0813.xml |
| 035 | |a (DE-627)NLM24404466X | ||
| 035 | |a (NLM)25449882 | ||
| 035 | |a (PII)S0883-9441(14)00405-5 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Eastwood, Glenn M |e verfasserin |4 aut | |
| 245 | 1 | 2 | |a A pilot assessment of alpha-stat vs pH-stat arterial blood gas analysis after cardiac arrest |
| 264 | 1 | |c 2015 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 16.03.2015 | ||
| 500 | |a Date Revised 02.12.2018 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2014 Elsevier Inc. All rights reserved. | ||
| 520 | |a PURPOSE: Resuscitated cardiac arrest (CA) patients typically receive therapeutic hypothermia, but arterial blood gases (ABGs) are often assessed after adjustment to 37°C (alpha-stat) instead of actual body temperature (pH-stat). We sought to compare alpha-stat and pH-stat assessment of PaO2 and PaCO2 in such patients | ||
| 520 | |a MATERIALS AND METHODS: Using ABG data obtained during the first 24 hours of intensive care unit admission, we determined the impact of measured alpha vs calculated pH-stat on PaO2 and PaCO2 on patient classification and outcomes for CA patients | ||
| 520 | |a RESULTS: We assessed 1013 ABGs from 120 CA patients with a median age of patients 66 years (interquartile range, 50-76). Median alpha-stat PaO2 changed from 122 (95-156) to 107 (82-143) mm Hg with pH-stat and median PaCO2 from 39 (34-46) to 35 (30-41) mm Hg (both P < .001). Using the categories of hyperoxemia, normoxemia, and hypoxemia, pH-stat estimation of PaO2 reclassified approximately 20% of patients. Using the categories of hypercapnia, normocapnia, and hypocapnia, pH stat estimation of PaCO2 reclassified approximately 40% of patients. The mortality of patients in different PaO2 and PaCO2 categories was similar for pH-stat and alpha-stat | ||
| 520 | |a CONCLUSIONS: Using the pH-stat method, fewer resuscitated CA patients admitted to intensive care unit were classified as hyperoxemic or hypercapnic compared with alpha-stat. These findings suggest an impact of ABG assessment methodology on PaO2, PaCO2 , and patient classification but not on associated outcomes | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Arterial blood gas | |
| 650 | 4 | |a Cardiac arrest | |
| 650 | 4 | |a Hyperoxemia | |
| 650 | 4 | |a Hypocapnia | |
| 650 | 4 | |a Hypoxemia | |
| 650 | 4 | |a Intensive care | |
| 700 | 1 | |a Suzuki, Satoshi |e verfasserin |4 aut | |
| 700 | 1 | |a Lluch, Cristina |e verfasserin |4 aut | |
| 700 | 1 | |a Schneider, Antoine G |e verfasserin |4 aut | |
| 700 | 1 | |a Bellomo, Rinaldo |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Journal of critical care |d 1987 |g 30(2015), 1 vom: 15. Feb., Seite 138-44 |w (DE-627)NLM074731068 |x 1557-8615 |7 nnns |
| 773 | 1 | 8 | |g volume:30 |g year:2015 |g number:1 |g day:15 |g month:02 |g pages:138-44 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.jcrc.2014.09.022 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 30 |j 2015 |e 1 |b 15 |c 02 |h 138-44 | ||