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Intern Med J ; 49(7): 834-837, 2019 07.
Article in English | MEDLINE | ID: mdl-30515940

ABSTRACT

BACKGROUND: Many patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) have type 2 respiratory failure (T2RF). Often arterial blood gases are not performed and correlation with venous blood gases (VBG) is controversial. The venous pH and bicarbonate (HCO3 ) are useful, but VBG pCO2 (PvCO2 ) is considered too unpredictable. AIM: To examine the utility of VBG in this cohort of patients. METHODS: A prospective study of AECOPD patients with T2RF presenting to the emergency department was performed. Patients being considered for non-invasive ventilation and who required an arterial blood gas were invited to participate. A subsequent VBG was also taken, and Bland-Altman plots were used for analysis. RESULTS: Sixty-three patients were included in this study. The limits of agreement for pH and HCO3 were narrow. Wider limits of agreement with a systematic bias of 7.7 mmHg were noted with pCO2 . CONCLUSIONS: The utility of VBG pH and HCO3 was again demonstrated. VBG pCO2 in this cohort of patients may have a role in the assessment of patients with AECOPD. Further study is needed on the possible role of VBG in the management of such patients with T2RF particularly those using non-invasive ventilation.


Subject(s)
Emergency Service, Hospital , Hypercapnia/blood , Pulmonary Disease, Chronic Obstructive/blood , Respiratory Insufficiency/blood , Aged , Aged, 80 and over , Blood Gas Analysis/methods , Cohort Studies , Female , Humans , Hypercapnia/epidemiology , Hypercapnia/therapy , Male , Middle Aged , Prospective Studies , Pulmonary Disease, Chronic Obstructive/epidemiology , Pulmonary Disease, Chronic Obstructive/therapy , Respiratory Insufficiency/epidemiology , Respiratory Insufficiency/therapy
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