Introducción: la gasometría venosa periférica puede ser de utilidad en sujetos con exacerbación de la enfermedad pulmonar obstructiva crónica para evaluar su intercambio gaseoso.
Objetivo: describir la variabilidad de los parámetros de la gasometría arterial y venosa periférica en sujetos con enfermedad pulmonar obstructiva crónica en condición estable.
Métodos: diseño transversal, se estudiaron sujetos consecutivos de forma cegada, al mismo tiempo se obtuvo sangre arterial y venosa periférica para su análisis. La variabilidad se determinó con el método estadístico de Bland-Altman y su magnitud con el coeficiente de correlación intraclase (intervalo de confianza al 95%).
Resultados: se estudiaron 300 muestras sanguíneas de 150 pacientes, 89 mujeres (59.3%), edad del grupo 66 ± 10 años, el índice de masa corporal 28.44 ± 4.81 Kg/m2. La diferencia media (sesgo) [coeficiente de correlación intraclase] para el pH: 0.012 (-0.009, 0.032) [0.927], presión de bióxido de carbono: -6.5 (-14.1, 1.1) [ 0.643], bicarbonato sérico: -1.3 (-3.3, 0.7) [0.929], y exceso de base: -1 (-4, 2.1) [0.904], hemoglobina: -0.1 (-1.9, 1.8) [0.947].
Conclusiones: la variabilidad del pH, el bicarbonato sérico y la hemoglobina son similares en ambas muestras sanguíneas. Estos parámetros de la gasometría arterial o venosa periférica podrían ser utilizados en forma intercambiable.
Rennard IS, Bradley D. Early chronic pulmonary disease: definitions, assessment and prevention. Lancet. 2015;385:1778-88.
O´Donnell DE, Laveneziana P, Webb K, Neder JA. Chronic Obstructive pulmonary disease. Clinical integrative physiology. Clin Chest Med. 2014;35:51-69.
Jeong SH, Lee H, Carriere KC, Shin SH, Moon SM, Jeong BH, et al. Comorbidity as a contributor to frequent severe acute exacerbation in COPD patients. Int J Chron Obstruct Pulmon Dis. 2016:11:1857-65.
Mortensen JD. Clinical sequelae from arterial needle puncture, cannulation, and incision. Circulation. 1967;35:1118-23.
Santos-Martínez LE, Martínez-Guerra ML, Duran A, Rodríguez F, Gotés J, Roquet I, et al. Capillary blood gas test usefulness to evaluate gas exchange with 21% and 100% of oxygen inspired fractions in subjects with stable cardiopulmonary disease at 2,240 meters above sea level. Arch Cardiol Mex. 2009;79(1):18-26.
Kelly AM. Can peripheral venous blood gases replace arterial blood gases in emergency medical care. Emerg Med Australas. 2010;22:493-8.
Kelly AM, Kyle E, McAlpine R. Venous pCO2 and pH can be used to screen for significant hypercarbia in emergency patients with acute respiratory disease. J Emerg Med. 2002;22(1):15-9.
Kelly AM, Kerr D, Middleton P. Validation of venous pCO2 to screen for arterial hypercarbia in patients with chronic obstructive airways disease. J Emerg Med. 2005;28(4):377-9.
Ak A, Ogun CO, Bayir A, Kayis SA, Koylu R. Prediction of arterial blood gas values from venous blood gas values in patients with acute exacerbation of chronic obstructive pulmonary disease. Tohoku J Exp Med. 2006;210(4):285-90.
Razi E, Moosavi GA. Comparison of arterial and venous blood gases analysis in patients with exacerbation of chronic obstructive pulmonary disease. Saudi Med J. 2007;28(6):862-5.
McCanny P, Bennett K, Staunton P, McMahon G. Venous vs arterial blood gases in the assessment of patients presenting with an exacerbation of chronic obstructive pulmonary disease. Am J Emerg Med. 2012;30(6):896-900.
McKeever TM, Hearson G, Housley G, Reynolds C, Kinnear W, Harrison TW, et al. Using venous blood gas analysis in the assessment of COPD exacerbations: a prospective cohort study. Thorax. 2016;71(3):210-5.
Lim BL, Kelly AM. A meta-analysis on the utility of peripheral venous blood gas analyses in exacerbations of chronic obstructive pulmonary disease in the emergency department. Eur J Emerg Med. 2010;17(5):246-8.
Celli BR, Decramer M, Wedzicha JA, Wilson KC, Agustí A, Criner GJ, et al. An Official American Thoracic Society/European Respiratory Society Statement: Research questions in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2015;191(7):e4-e27.
Allen EV. Thromboangitis obliterans: Methods of diagnosis of chronic occlusive arterial lesions distal to the wrist with illustrative cases. Am J Med Sci. 1929;178:237-44.
Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986;1:307-10.
Brandenburg MA, Dire DJ. Comparison of arterial and venous blood gas values in the initial emergency department evaluation of patients with diabetic ketoacidosis. Ann Emerg Med. 1998;31(4):459-65.
Malatesha G, Singh NK, Bharija A, Rehani B, Goel A. Comparison of arterial and venous pH, bicarbonate, PCO2 and PO2 in initial emergency department assessment. Emerg Med J. 2007;24(8):569-71.
Masip J, De Mendoza D, Planas K, Paez J, Sanchez B, Cancio B. Peripheral venous blood gases and pulse-oximetry in acute cardiogenic pulmonary oedema. Eur Heart J Acute Cardiovasc Care. 2012;1(4):275-80.
Kim BR, Park SJ, Shin HS, Jung YS, Rim H. Correlation between peripheral venous and arterial blood gas measurements in patients admitted to the intensive care unit: A single-center study. Kidney Res Clin Pract. 2013;32(1):32-8.
Kramer MS, Feinstein AR. Clinical biostatistics LIV. The biostatistics of concordance. Clin Pharmacol Ther. 1981;29:111-23.
Rudkin SE, Kahn CA, Oman JA, Dolich MO, Lotfipour S, Lush S, et al. Prospective correlation of arterial vs venous blood gas measurements in trauma patients. >Am J Emerg Med. 2012;30(8):1371-7.