Related Experiment Video
Updated: Jan 17, 2026
Observational Study Protocol for Repeated Clinical Examination and Critical Care Ultrasonography Within the Simple Intensive Care Studies
Published on: January 16, 2019
Optimising the frequency of routine arterial blood gas testing in the intensive care unit: An observational study
James W Cuskelly1, Craig A McDonald2
1Intensive Care Unit, Cairns Hospital, Queensland, Australia; James Cook University, Townsville, Queensland, Australia.
Background:
Arterial blood gas (ABG) testing is a broadly utilised tool in intensive care units (ICUs), though there is an acceptance that an excessive number are performed routinely. Reducing collection frequency has previously demonstrated no impact on benchmarked outcomes. This observational study assessed the impact of reducing routine ABG testing frequency on critical value detection, routine bedside interventions, and patient outcomes.
Objective:
The objective of this study was to evaluate the safety and clinical utility of routine ABG collection by reviewing test frequency, critical value detection, bedside interventions (including respiratory support and electrolyte supplementation), and patient outcomes.
Methods:
This observational study compared three time periods (preintervention, postintervention, and 1-year follow-up) between 2019 and 2021, following implementation of an ABG testing protocol in February 2020. ABG testing frequency and associated critical values were recorded alongside routine bedside interventions (system support changes).
Setting:
The study was conducted in Cairns Hospital ICU, a regional mixed ICU in Australia with approximately 1200 annual admissions.
Participants:
Adult patients admitted for over 24 h without an established need for high-frequency ABG collection participated in the study.
Results:
ABG use decreased significantly from 4.93 to 3.06 tests per patient per day (p < 0.001), sustained at 1-year follow-up. The proportion of patients with at least one critical value detected did not differ significantly (57% vs. 49%, p = 0.06), though the number of critical values per patient per day declined (3.89 vs. 2.99, p < 0.001). Rates of respiratory support changes-including adjustments in fraction of inspired oxygen, type of respiratory support, and amount of positive end-expiratory pressure-were not significantly reduced. Potassium supplementation remained similar (27.10 mEq/day vs. 26.20 mEq/day, p = 0.288). Mortality was unchanged (6.5% vs. 11.5%, p = 0.074).
Conclusion:
Routine ABG analysis is associated with overtesting. A routine ABG collection protocol supported by staff education significantly reduces their collection frequency without compromising day-to-day care or overall patient outcomes.
More Related Videos
14:28Non-Invasive Monitoring of Microvascular Oxygenation and Reactive Hyperemia using Hybrid, Near-Infrared Diffuse Optical Spectroscopy for Critical Care
Published on: May 10, 2024
07:52Expired CO2 Measurement in Intubated or Spontaneously Breathing Patients from the Emergency Department
Published on: January 29, 2011
Related Concept Videos
01:26Blood Studies I: ABG and VBG
Arterial Blood Gas (ABG)
Arterial Blood Gas (ABG) studies are crucial for assessing the lungs' ability to supply oxygen and remove carbon dioxide, reflecting the patient's ventilation status. They also help understand the kidneys' capacity to...
01:19Special considerations while measuring oxygen saturation
Ensuring accuracy in vital sign recordings while prioritizing patient comfort and minimizing anxiety is...
01:20Assessment of Ventilation I: Respiratory Rate
A Ventilation assessment is critical for monitoring a patient's health status. Respiration, one of the most accessible vital signs, provides insights into the function of numerous body systems and can indicate serious health issues, such as brainstem injuries from head trauma.
Critical Guidelines for Assessing Ventilation:
01:17Assessment of Diffusion and Perfusion
The Role of Diffusion in Respiration
Diffusion is the process by which molecules move from an area of higher concentration to an area of lower concentration. In the respiratory system, this...
01:19Respiratory Assessment: Purpose and Indications
Objectives and Importance:
The primary goal of respiratory assessment is to evaluate patients at early risk of clinical deterioration. Since respiratory distress often precedes other signs of declining health, breathing patterns and sounds become a...