Middleton P, Kelly A-M, Brown J, Robertson M
Public Health and Community Medicine, University of New South Wales and Prince of Wales Hospital, Randwick, NSW, Australia.
Emerg Med J. 2006 Aug;23(8):622-4. doi: 10.1136/emj.2006.035915.
This study aimed to determine the extent of agreement between central venous and arterial values for pH, bicarbonate, base excess, and lactate in a group of intensive care unit (ICU) patients.
A prospective study of a convenience sample of patients deemed by their treating doctor to require blood gas analysis as part of their clinical care in ICU. It compared pH, bicarbonate, base excess and lactate on arterial and central venous samples taken within five minutes of each other. Data were analysed using bias (Bland-Altman) methods.
A total of 168 matched sample pairs from 110 patients were entered into the study. All variables showed close agreement. The mean difference between arterial and venous values of pH was 0.03 pH units, for bicarbonate 0.52 mmol/l, for lactate 0.08 mmol/l, and for base excess 0.19 mmol/l. All showed acceptably narrow 95% limits of agreement.
Central venous pH, bicarbonate, base excess, and lactate values showed a high level of agreement with the respective arterial values, with narrow 95% limits of agreement. These results suggest that venous values may be an acceptable substitute for arterial measurement in this clinical setting.
本研究旨在确定一组重症监护病房（ICU）患者的中心静脉血与动脉血在pH值、碳酸氢盐、碱剩余和乳酸水平上的一致性程度。
对一组方便样本进行前瞻性研究，这些患者经主治医生判断在ICU临床治疗中需要进行血气分析。比较动脉血和中心静脉血样本在彼此5分钟内采集的pH值、碳酸氢盐、碱剩余和乳酸水平。采用偏倚（Bland-Altman）方法分析数据。
共纳入110例患者的168对匹配样本进行研究。所有变量均显示出高度一致性。动脉血与静脉血pH值的平均差值为0.03个pH单位，碳酸氢盐为0.52 mmol/L，乳酸为0.08 mmol/L，碱剩余为0.19 mmol/L。所有指标的95%一致性界限均在可接受范围内。
中心静脉血的pH值、碳酸氢盐、碱剩余和乳酸水平与相应动脉血值高度一致，95%一致性界限较窄。这些结果表明，在此临床环境中，静脉血值可能是动脉血检测的可接受替代指标。
