糖尿病酮症酸中毒患者在急诊科初始评估时动脉血气值与静脉血气值的比较。

Comparison of arterial and venous blood gas values in the initial emergency department evaluation of patients with diabetic ketoacidosis.

作者信息

Brandenburg M A, Dire D J

机构信息

Section of Emergency Medicine & Trauma, University of Oklahoma Health Sciences Center, Oklahoma City, USA.

出版信息

Ann Emerg Med. 1998 Apr;31(4):459-65. doi: 10.1016/s0196-0644(98)70254-9.

DOI:10.1016/s0196-0644(98)70254-9

PMID:9546014

Abstract

STUDY OBJECTIVE

To determine whether venous blood gas values can replace arterial gas values in the initial emergency department evaluation of patients with suspected diabetic ketoacidosis.

METHODS

This prospective comparison was performed in an adult university teaching hospital ED. Samples for arterial and venous blood gas analysis were obtained during initial ED evaluations. The venous gas samples were collected with samples for other blood tests at the time of intravenous line insertion. Both arterial and venous samples were obtained before the initiation of treatment.

RESULT

Data from 44 episodes of diabetic ketoacidosis in 38 patients were analyzed. Laboratory findings of those patients with diabetic ketoacidosis were as follows (mean +/- SD): arterial pH, 7.20 +/- 14; venous pH, 7.17 +/- 13; serum glucose, 33.8 +/- 16 mmol/L (609 +/- 288 mg/dL); arterial HCO3-, 11.0 +/- 6.0 mmol; venous HCO3-, 12.8 +/- 5.5 mmol/L; serum CO2, 11.8 +/- 5.0 mmol/L; and anion gap, 26.7 +/- 7.6 mmol/L. The mean difference between arterial and venous pH values was 0.03 (range 0.0 to 0.11). Arterial and venous pH results (r = .9689) and arterial and venous HCO3- results (r = .9543) were highly correlated and showed a high measure of agreement.

CONCLUSION

Venous blood gas measurements accurately demonstrate the degree of acidosis of adult ED patients presenting with diabetic ketoacidosis.

摘要

研究目的

确定在急诊科对疑似糖尿病酮症酸中毒患者进行初始评估时，静脉血气值是否可替代动脉血气值。

方法

在一所成人大学教学医院的急诊科进行了这项前瞻性比较研究。在急诊科初始评估期间采集动脉和静脉血气分析样本。静脉血气样本在插入静脉输液管时与其他血液检测样本同时采集。动脉和静脉样本均在开始治疗前获取。

结果

分析了38例患者44次糖尿病酮症酸中毒发作的数据。这些糖尿病酮症酸中毒患者的实验室检查结果如下（均值±标准差）：动脉血pH值为7.20±0.14；静脉血pH值为7.17±0.13；血清葡萄糖为33.8±16 mmol/L（609±288 mg/dL）；动脉血HCO₃⁻为11.0±6.0 mmol；静脉血HCO₃⁻为12.8±5.5 mmol/L；血清CO₂为11.8±5.0 mmol/L；阴离子间隙为26.7±7.6 mmol/L。动脉血和静脉血pH值的平均差值为0.03（范围为0.0至0.11）。动脉血和静脉血pH结果（r = 0.9689）以及动脉血和静脉血HCO₃⁻结果（r = 0.9543）高度相关且一致性程度高。