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The Oxygen Status Algorithm on-line with the pH-blood gas analyzer

V H Larsen¹, O Siggaard-Andersen

¹Department of Anaesthesiology, Herlev Hospital, University of Copenhagen, Denmark.

Scandinavian Journal of Clinical and Laboratory Investigation. Supplementum

|January 1, 1996

Summary

The Oxygen Status Algorithm enhances blood gas analysis interpretation in intensive care units. Routine application revealed insights into oxygen transport and facilitated program improvements for better patient care.

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Area of Science:

Medical Informatics
Clinical Chemistry
Critical Care Medicine

Background:

The Oxygen Status Algorithm (OSA) is a computer program for interpreting pH-blood gas measurements.
Recent implementation allows on-line data transfer from ABL 520 analyzers for instant calculation, graphical display, and print-out of blood oxygen and acid-base status.

Purpose of the Study:

To report on the routine application of the OSA in an intensive care unit.
To detail recent enhancements to the OSA program.

Main Methods:

Analysis of routine pH-blood gas data over a two-year period.
Average of 40 analyses performed daily.

Main Results:

Unexpected findings included abnormal hemoglobin-oxygen affinity, suggesting low 2,3-diphosphoglycerate and hypophosphatemia.

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Oxygen administration criteria were revised based on oxygen extraction tension.

Program expanded for cumulated patient reports and calculation of oxygen consumption rate.

Continuous operation of program and hardware was successful, though consistent input of patient temperature and inspired oxygen fraction proved challenging.

Conclusions:

The OSA offers a more detailed interpretation of blood oxygen and acid-base status compared to existing methods.
Graphical display of arterial oxygen tension, hemoglobin oxygen capacity, and affinity, with oxygen extraction tension quantifying compensation.
Interactive interpretation allows rapid prediction of therapeutic intervention effects.
Successful routine implementation requires comprehensive training for medical and laboratory staff.