Reference intervals for venous blood gas measurement in adults

Kirsty L. Ress, Gus Koerbin, Ling Li, Douglas Chesher, Phillip Bwititi, Andrea R Horvath

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: Venous blood gas (VBG) analysis is becoming a popular alternative to arterial blood gas (ABG) analysis due to reduced risk of complications at phlebotomy and ease of draw. In lack of published data, this study aimed to establish reference intervals (RI) for correct interpretation of VBG results.

Methods: One hundred and 51 adult volunteers (101 females, 50 males 18-70 y), were enrolled after completion of a health questionnaire. Venous blood was drawn into safePICO syringes and analysed on ABL827 blood gas analyser (Radiometer Pacific Pty. Ltd.). A non-parametric approach was used to directly establish the VBG RI which was compared to a calculated VBG RI based on a meta-analysis of differences between ABG and VBG.

Results: After exclusions, 134 results were used to derive VBG RI: pH 7.30-7.43, partial pressure of carbon dioxide (pCO2) 38-58 mmHg, partial pressure of oxygen (pO2) 19-65 mmHg, bicarbonate (HCO3-) 22-30 mmol/L, sodium 135-143 mmol/L, potassium 3.6-4.5 mmol/L, chloride 101-110 mmol/L, ionised calcium 1.14-1.29 mmol/L, lactate 0.4-2.2 mmol/L, base excess (BE) -1.9-4.5 mmol/L, saturated oxygen (sO2) 23-93%, carboxyhaemoglobin 0.4-1.4% and methaemoglobin 0.3-0.9%. The meta-analysis revealed differences between ABG and VBG for pH, HCO3-, pCO2 and pO2 of 0.032, -1.0 mmol/L, -4.2 and 39.9 mmHg, respectively. Using this data along with established ABG RI, calculated VBG RI of pH 7.32-7.42, HCO3- 23 - 27 mmol/L, pCO2 36-49 mmHg (Female), pCO2 39-52 mmHg (Male) and pO2 43-68 mmHg were formulated and compared to the VBG RI of this study.

Conclusions: An adult reference interval has been established to assist interpretation of VBG results.

Original languageEnglish
Pages (from-to)947-954
Number of pages8
JournalClinical Chemistry and Laboratory Medicine
Volume59
Issue number5
Early online date3 Dec 2020
DOIs
Publication statusPublished - 27 Apr 2021

Keywords

  • blood gas analysis
  • reference intervals
  • venous blood

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