Venous and arterial base deficits: Do these agree in occult shock and in the elderly? A Bland-Altman analysis

Tanya Zakrison, Amanda Mcfarlan, Yan Yan Wu, Itay Keshet, Avery Nathens

Research output: Contribution to journalArticle

6 Scopus citations

Abstract

Background: Trauma centers are increasingly advocating the replacement of arterial blood gas measurements with venous blood gas measurements for simplification of base deficit (BD) determination. These values have never been demonstrated to agree in important trauma populations, such as for patients in occult shock (OS) or the elderly. The goal of this study was to investigate the level of agreement between venous and arterial BDs from blood gases in critically ill or injured patients, specifically in OS and the elderly. Methods: This is a retrospective, consecutive, cohort study using matched pairs of venous and arterial blood gases from patients admitted to the Trauma and Neurosurgery Intensive Care Unit in a Level I trauma center in Toronto, Ontario, Canada. Agreement between near simultaneous arterial and venous BD was calculated using the Bland-Altman method. McNemar's test was used for differences in BDs in the presence or absence of OS and in elderly patients. Results: BDs for 466 arterial and venous samples from 72 patients were compared pairwise. There was no significant difference between samples (p = 0.88). Ninety-eight percent of samples were within 3.0 mmol/L of each other. No significant differences were detected between venous and arterial BD in the presence of OS or in the elderly (p = 0.72 and p = 0.25, respectively). Conclusion: Arterial and venous BDs agree, including in the presence of OS and in the elderly. Consideration may be given to venous sampling both in the intensive care unit or in other areas of care, such as the trauma bay.

Original languageEnglish
Pages (from-to)936-939
Number of pages4
JournalJournal of Trauma and Acute Care Surgery
Volume74
Issue number3
DOIs
StatePublished - Mar 1 2013

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Keywords

  • Base deficit
  • Bland-Altman
  • Elderly
  • Occult shock

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Surgery

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