Comparison of Blood Gas and Acid–Base Measurement in Arterial and Venous Blood Samples in Patients with Diabetic Ketoacidosis
Sandeep K. Immadisetty
and Aparna P. Patange*Department of General Medicine, Krishna Institute of Medical Sciences (Deemed to be University), Karad, Maharashtra, India - 415110.
Corresponding Author E-mail: kimssubmission1@gmail.com
Abstract: Background Diabetic ketoacidosis (DKA) is one of the most severe complications of diabetes mellitus (DM). Arterial blood gas analysis (ABGA) has been used as a conclusive diagnostic test for DKA. However, ABGA sampling is technically challenging, painful and may cause multiple complications. Venous blood gas analysis (VBGA) is a minimally invasive alternative for ABGA; however, the correlation between ABGA and VBGA has been controversial. Thus, the correlation between arterial and venous pH, partial pressure of CO2 (PCO2), and bicarbonate (HCO3) was studied. Objective To determine whether VBGA can replace ABGA in the evaluation of patients presenting with DKA. Material and Methods The present observational study was carried out in 76 patients with DKA. Two samples for ABGA and VBGA were obtained from each patient as close to each other as possible and were immediately sent to the laboratory. Data analysis was done using Pearson’s correlation coefficient (R) and Bland and Altman plots. Results The Bland and Altman plots and Pearson’s correlation coefficient depicted excellent agreement between arterial and venous pH (R = 0.69) and acceptably good agreement between arterial and venous PCO2 (R = 0.93) and HCO3 (R = 0.82). Conclusion Thus, VBGA can be used in the initial diagnosis and evaluation of DKA, allowing the utilisation of a minimally invasive, safer option to ABGA.
Keywords: Blood Gas Analysis; Diabetic Ketoacidosis; Diagnostic Tests; Hydrogen-Ion Concentration Back to TOC