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J Crit Care. 2015 Apr;30(2):438.e1-5. doi: 10.1016/j.jcrc.2014.10.025. Epub 2014 Nov 6.

Reevaluation of the utilization of arterial blood gas analysis in the Intensive Care Unit: effects on patient safety and patient outcome.

Author information

1
Department of Internal Medicine, Weiss Memorial Hospital, affiliate of the University of Illinois, Chicago, IL. Electronic address: fblum@weisshospital.com.
2
Department of Internal Medicine, Weiss Memorial Hospital, affiliate of the University of Illinois, Chicago, IL.
3
Department of Vascular Surgery, Weiss Memorial Hospital, Chicago, IL.
4
Department of Cardiovascular and Thoracic Surgery, Weiss Memorial Hospital, Chicago, IL; Department of Cardiothoracic Surgery, University of Illinois-Chicago at Chicago, Chicago, IL.
5
Department of Internal Medicine, Weiss Memorial Hospital, affiliate of the University of Illinois, Chicago, IL; Department of Medicine, Section of Pulmonary, Critical Care, Sleep and Allergy, University of Illinois-Chicago at Chicago, Chicago, IL.

Abstract

PURPOSE:

Arterial blood gas (ABG) analysis is a useful tool to evaluate hypercapnia in the context of conditions and diseases affecting the lungs. Oftentimes, indications for ABG analysis are broad and nonspecific and lead to frequent testing without test results influencing patient management.

MATERIALS AND METHODS:

Electronic charts of 300 intensive care unit (ICU) patients at a single institution were reviewed retrospectively. Reassessment of indications for ABGs led to a decrease of the number of ABGs in the ICU between March and November 2012. Data relating to ventilator days, length of stay, number of reintubations, mortality, complications after arterial puncture, demographics, and medications in 159 ICU patients between December 2011 and February 2012 (group 1) were compared with 141 ICU patients between December 2012 and February 2013 (group 2). Subgroup analysis in ventilated patients was performed.

RESULTS:

A decrease of number of ABGs per patient (6.12 ± 5.9, group 1 vs 2.03 ± 1.66, group 2 in ventilated patients; P = .007) was found along with a decrease in the number of ventilator days per patient (P = .004) and a shorter length of stay for ventilated patients in group 2 compared with group 1 (P = .04).

CONCLUSION:

A significant decrease of ABGs obtained in the ICU does not negatively impact patient outcome and safety. A decrease in the number of ABGs per patient allows cost-efficient patient care with a lower risk for complications.

KEYWORDS:

Arterial blood gas; Intensive care unit; Routine testing; Unnecessary testing; Ventilator days

PMID:
25475075
DOI:
10.1016/j.jcrc.2014.10.025
[Indexed for MEDLINE]

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