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العنوان
Arterial and venous blood gases correlation in post cardiac surgery patients \
المؤلف
Ghazy, Mohamed Bedair.
هيئة الاعداد
باحث / محمد بدير غازي
مشرف / بهاء الدين عويس حسن
مشرف / أحمد نجاح الشاعر
مناقش / بهاء الدين عويس حسن
تاريخ النشر
2021.
عدد الصفحات
66 p. :
اللغة
الإنجليزية
الدرجة
الدكتوراه
التخصص
العناية المركزة والطب العناية المركزة
تاريخ الإجازة
1/1/2021
مكان الإجازة
جامعة عين شمس - كلية الطب - الرعاية المركزة العامة
الفهرس
Only 14 pages are availabe for public view

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Abstract

• The aim of our study was to examine the correlation between the arterial and central VBG in patients undergoing open heart surgery either CABG or valve replacement.
• Our study was conducted over 50 patients, 24 female corresponding 48% of total number of patient and 26 male corresponding 52% of total number of patients.
• Age ranged from 22 years to 60 years old with mean age 51 and SD +/- 9.6. 64% of patients were diabetic (32 patients) while 62% were hypertensive (62%).
• 35 patients had ischemic heart diseases only corresponding 70% of total number of patients while 11 patients had valvular hear diseases that need replacement valve surgery corresponding to 22% of total number of patients.
• 4 patients underwent combined CABG and valve replacement surgery 8% of total number of patients .
• Comparing the five sets of both arterial and venous blood gases withdrawn at same time to the 50 patients at skin incision in the operating room, 2 hours after skin incision, at skin Closure in the operating room, at Fio2 70% in the intensive care unit and Fio2 40% in the ICU and one from central vein and the other from radial artery there were no statistically significant difference between them regarding PH, HCO3, lactate level and PaCO2 levels.
• Also There were strong positive correlation between arterial and venous PH,HCO3 and lactate values in all sampled withdrawn from all patient of the study .
• 47 patients out of 50 weaned from ventilation and inotropes while 3 patients was complicated and failed weaning of both .
• 4 patients was died one of them at operating room and 3 patients in the ICU .
• Those who died was 4 patients there were no statistically significant difference regarding parameters of blood gasses in venous and arterial samples expect for Pao2 and Sao2 .
• The study findings showed a strong and significant correlation and agreement between the ABG and VBG related variables. And this finding goes with results of Treger R ,et al .
• In a meta-analysis in 2014 by Bloom BM et al., evaluated the differences between ABG and VBG variables [6]. They found a pooled mean difference of 0.033 (vs. 0.046 in our study) and 1.03 (vs. 1.41 in our study) for pH and bicarbonate between arterial and venous samples, respectively. Regarding PCO2 they found a mean difference of 4.41 (vs. 6.59 in our study) mmHg among studies. Overall they found venous pH and bicarbonate were good representative of ABG, although for PCO2 it was not the same.
• We concluded that Central VBG with respect to the accuracy of pulse oximetry measurements in determining the exact PO2 status, for the rest of the indices a central VBG rather than an ABG can be utilised for determining patient’s acid-base status. Particularly in patients who are hospitalised for a long time and who have a central venous catheter in place like patients who have undergone CABG, thus reducing the risk and need for invasive arterial sampling.