A method for calculation of arterial acid-base and blood gas status from measurements in the peripheral venous blood

Abstract

In non-emergency medical departments such as internal medicine sampling of arterial blood and analysis for acid-base status is not routinely performed. Peripheral venous blood is routinely taken but interpretation of its acid-base status is difficult. This paper presents a method for calculation of arterial acid-base and blood gas status from measurements in peripheral venous blood combined with a pulse oximeter measurement of arterial saturation. The use of the method has been illustrated using the data of three patients with different acid-base, haemodynamic, and metabolic conditions. The sensitivity of the method has been tested for measurement errors including venous blood acid-base and blood gas status and pulse oximetry; errors due to physiological assumptions including the values of RQ and strong acid production at the tissues; and errors due to air bubbles in the blood. Errors due to these effects are relatively insignificant except for errors in calculated arterial PO(2), particularly when SpO(2) is greater than 97%; and errors when the change in base excess across the sampling site due to strong acid production is greater that 1.3 mmol/l.