Hypoxemic patients and those with shock get an arterial blood gas - Skyler Lentz MD


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HWN Suggests

Blood Gases: ABG vs. VBG

Hypoxemic patients, those with ARDS, and patients with poor circulation that prohibits plethysmography by pulse oximeter should have an ABG, because a VBG cannot be used to determine oxygenation. In such patients, this means you can start with an ABG and then correlate your end tidal CO2 and oxygenation with pulse oximetry (if oximetry then improves). If you are concerned about the patient’s metabolic acid-base status, a VBG will give you a pH, HCO3, lactate and BD that closely approximates the ABG. A venous pCO2 <45 mmHg will reliably screen for hypercarbia on a VBG, but the actual value may vary from that of an ABG with an average difference ranging from 5.7- 8.6mmHg.

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 Blood Gases: ABG vs. VBG

This review will break down blood gas results into individual components to compare venous versus arterial results and evaluate whether these are clinically important differences.

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