THE ARTERIAL BLOOD GAS ANALYSIS IN SEPTIC SHOCK PATIENTS

Syed Ohidul Hoque*, Nasrin Chowdhury, Nazia Chowdhury and Mohammad Shafiul Islam

ABSTRACT

Objective: In this study our main goal is to evaluate the arterial blood gas analysis in septic shock patients. Method: This cross-sectional study was carried out at the ICU Department of Jalalabad Ragib Rabeya Medical College Hospital, Sylhet from January 2019 to June 2019. Total 40 patients admitted to the medical intensive care unit (MICU) aged 18 and older who fulfilled the definition of severe sepsis or septic shock were screened for enrollment. The criteria for exclusion were cardiopulmonary arrest, pregnancy, prisoner or other ward of the state, and absence of a central venous catheter. Results: During the study, most of the patients used tobacco 60% followed by 36% had CAD, 34% had diabetes mellitus, 21% had peripheral vascular disease, 9% had kidney diseases, 1% had cirrhosis. Intraclass correlation between arterial and venous blood gas measurements among patients with severe sepsis or septic shock where a significant correlation, in each of the three pairs, was found for pH, pCO2, HCO3, and BE, with an ICC > 0.85 found. Also, in arterial blood gas mean pH was 7.35 ± 0.09, mean pCO2 was 39.9 ± 11.2 mm Hg, mean pO2 was 115 ± 61.0 mmHg, mean Bicarbonate was 21.6 ± 6.4 mmol/L. where as in pVBG, peripheral venous blood gas mean pH was 7.32 ± 0.10, mean pCO2 was 45.8 ± 12.9 mm Hg, mean pO2 was 62.0 ± 33.8 mmHg, mean Bicarbonate was 23.0 ± 6.6 mmol/L. and in cVGB, central venous blood gas mean pCO2 was 45.2 ± 11.1 mm Hg, mean pO2 was 52.3 ± 20.1 mmHg, mean Bicarbonate was 22.8 ± 6.6 mmol/L, mean pH was 7.31 ± 0.09. Conclusion: Adequate correlation and agreement between ABG/pVBG, ABG/cVBG, and pVBG/cVBG comparisons was found only for pH. The current level of evidence does not support the use of venous blood gas sampling in this setting.

Keywords: Blood gas, septic shock, severe sepsis.