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Respirology. 2014 Feb;19(2):168-175. doi: 10.1111/resp.12225. Epub 2014 Jan 3.

Peripheral venous and arterial blood gas analysis in adults: are they comparable? A systematic review and meta-analysis.

Author information

1
Department of Respiratory Medicine, Prince of Wales Hospital, Randwick, NSW, Australia.
2
Wales Anaesthesia, Prince of Wales Hospital, Randwick, NSW, Australia.
3
Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia.
4
Department of Anesthesiology, School of Medicine, University of Utah, Salt Lake City, UT, USA.
5
Inflammation and Infection Research Centre (IIRC), Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia.

Abstract

Peripheral venous blood gas (PVBG) analysis is increasingly being used as a substitute for arterial blood sampling; however, comparability has not been clearly established. To determine if the pH, PCO2 and PO2 obtained from PVBG analysis is comparable with arterial blood gas (ABG) analysis. A search was conducted of electronic databases as well as hand-searching of journals and reference lists through December 2012 to identify studies comparing PVBG with ABG analysis in adult subjects. A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. A meta-analysis using a random effects model was used to calculate the average difference (bias) and the limits of agreement for the venous and arterial pH, PCO2 and PO2 . A total of 18 studies comprising 1768 subjects were included in the meta-analysis. There was considerable heterogeneity between studies with I(2) approaching 100%. There was little difference between the pH obtained from the PVBG and the ABG, with the arterial pH typically 0.03 higher than the venous pH (95% confidence interval 0.029-0.038). The venous and arterial PCO2 were not comparable because the 95% prediction interval of the bias for venous PCO2 was unacceptably wide, extending from -10.7 mm Hg to +2.4 mm Hg. The PO2 values compared poorly, the arterial PO2 typically 36.9 mm Hg greater than the venous with significant variability (95% confidence interval from 27.2 to 46.6 mm Hg). PVBG analysis compares well with ABG analysis for pH estimations in adults but not to the PCO2 or PO2 . These differences are sufficiently large to be of clinical significance.

KEYWORDS:

arterial; carbon dioxide; meta-analysis; pH; venous

PMID:
24383789
DOI:
10.1111/resp.12225
[Indexed for MEDLINE]
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