Clinically Acceptable Agreement

Studies conducted to date [21-27] have confirmed that the normal difference in venous arterio (central) (A-V) for pH and pCO2 (~0.03 pH units or ~-0.6 kPa) is maintained within generally acceptable limits for the population of patients requiring BGA. Only three studies [22-24] compared excess venous and central arterial (BE) baseline (see Table V). The mean A-V gap was small (-0.19 mmol/L and -0.18 mmol/L) and the 95% match limit was so narrow that one study author could conclude that the Venetian and central arterial values were interchangeable [24]. For comparison, the study [23] which showed the worst level of compliance with 95% of LOA -0.03 to 0.09, shows that with a measured central venous pH of 7.40, the arterial pH in 95% of patients would be between 7.37 and 7.49, with a peak close to 7.43. Four of the seven studies provided 95% LOA data. For the most compliant study [25], 95% of LOA were 0.008 to 0.063. Further research is expected to investigate the ViMove system`s ability to measure lumbar movements in more complex 3D movements and to measure changes in movement patterns related to treatment effects. Background: Blood gas arterial analysis (GBS) is common for sick patients, but it is complicated, painful and technically demanding. Objective: to determine the concordance between the arterial and peripheral venous measurement of pH, pCO2, pO2 and bicarbonate levels in patients with cardiopulmonal diseases in the Kashmir Valley, on the Indian subcontinent, in order to use venous analysis of gas instead of arteries to assess patients. Setting: Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, a 650-bed hospital for tertiary care in northern India at an altitude of 1584 m.

Methods: about a hundred patients requiring ABG analysis were admitted. Peripheral venous blood was collected within 5 minutes of measuring GBS and samples were immediately analyzed on an automated ABG analyzer at Point-of-Care. Finger oximetry was used to achieve oxygen saturation (SpO2). Data were analyzed using pearson correlation and bias methods (Bland Altman). Results: Venous measurements of pH, pCO 2, pO2 and bicarbonate, as well as numerical oxygen saturation, were strongly correlated with the corresponding arterial measurements. The Bland Altman diagrams showed a high degree of agreement between the two corresponding measures, with clinically acceptable differences. However, the difference in pO2 measurements was higher (-22.34 ± 15.23), although finger saturation and oximetry gave a good degree of compliance with clinically acceptable distortion. Conclusion: Peripheral analysis of venous blood gases combined with finger oximetry may make the routine use of arterial puncture superfluous in patients requiring abg analysis. We found 29 proposed functions to report on these studies. Eight of them were frequently found.

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