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Capillary blood gases in a pediatric intensive care unit
R Escalante-Kanashiro1, J Tantaleán-Da-Fieno
1Intensive Care Unit, Instituto de Salud del Niño, Department of Pediatrics, Universidad Nacional Federico Villarreal, Lima, Perú. rescalante@amnet.com.pe
Insights
Arterial and capillary blood gas samples are comparable in critically ill children, except during hypotension. Capillary sampling offers a viable alternative for blood gas analysis in pediatric intensive care units when patients are not hypotensive.
Area of Science:
- Pediatric Intensive Care
- Clinical Chemistry
- Critical Care Medicine
Background:
- Accurate blood gas analysis is crucial for managing critically ill children.
- Arterial blood sampling is invasive and may not always be feasible.
- Capillary blood sampling presents a less invasive alternative.
Purpose of the Study:
- To evaluate the comparability of arterial and capillary blood gas samples in pediatric intensive care unit (PICU) patients.
- To assess the influence of various clinical conditions on sample comparability.
Main Methods:
- A prospective, descriptive study was conducted in a multidisciplinary PICU.
- Seventy-five simultaneous paired arterial and capillary blood samples were collected.
- Samples were analyzed within 5 minutes of collection from patients with varying hemodynamic status.
Main Results:
- High average correlations were observed between arterial and capillary samples: 0.87 for pH and 0.86 for CO2.
- Oxygen (O2) correlation was lower at 0.65.
- Hypotension significantly impacted the correlation, while hypoperfusion and low temperature did not affect pH or CO2 correlations.
Conclusions:
- Capillary blood sampling is a reliable alternative for blood gas analysis in critically ill children.
- This alternative is useful even with hypothermia or hypoperfusion.
- The utility of capillary sampling is limited in the presence of hypotension.
Objective:
To determine if samples obtained from arterial and capillary sources are comparable in children with diverse pathologic conditions during their stay in a pediatric intensive care unit.
Study Design:
Prospective, descriptive study in patients admitted to a multidisciplinary pediatric intensive care unit.
Interventions:
Seventy-five simultaneous paired samples (arterial and capillary) were obtained from patients with different degrees of capillary reperfusion, hemodynamic stability, blood pressure, and temperature. Both samples were analyzed < or =5 mins after collection.
Measurements And Main Results:
The average correlations between arterial and capillary samples were 0.87 for pH, 0.86 for CO2, and 0.65 for oxygen. Neither poor perfusion nor low temperature altered the correlation for pH or CO2. The only condition that significantly affected the correlation was hypotension.
Conclusion:
Capillary blood sampling is a useful alternative to gasometric evaluation of critically ill children, even in the presence of hypothermia or hypoperfusion, provided that hypotension is not present.