A pilot assessment of alpha-stat vs pH-stat arterial blood gas analysis after cardiac arrest

Eastwood, Glenn M., Suzuki, Satoshi, Lluch, Cristina, Schneider, Antoine G. and Bellomo, Rinaldo 2015, A pilot assessment of alpha-stat vs pH-stat arterial blood gas analysis after cardiac arrest, Journal of critical care, vol. 30, no. 1, pp. 138-144, doi: 10.1016/j.jcrc.2014.09.022.

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Title A pilot assessment of alpha-stat vs pH-stat arterial blood gas analysis after cardiac arrest
Author(s) Eastwood, Glenn M.
Suzuki, Satoshi
Lluch, Cristina
Schneider, Antoine G.
Bellomo, Rinaldo
Journal name Journal of critical care
Volume number 30
Issue number 1
Start page 138
End page 144
Total pages 7
Publisher Elsevier
Place of publication Amsterdam, The Netherlands
Publication date 2015-02
ISSN 1557-8615
Keyword(s) arterial blood gas
cardiac arrest
intensive care
hyperoxemia
hypocapnia
hypoxemia
Summary PURPOSE: Resuscitated cardiac arrest (CA) patients typically receive therapeutic hypothermia, but arterial blood gases (ABGs) are often assessed after adjustment to 37°C (alpha-stat) instead of actual body temperature (pH-stat). We sought to compare alpha-stat and pH-stat assessment of PaO2 and PaCO2 in such patients. MATERIALS AND METHODS: Using ABG data obtained during the first 24 hours of intensive care unit admission, we determined the impact of measured alpha vs calculated pH-stat on PaO2 and PaCO2 on patient classification and outcomes for CA patients. RESULTS: We assessed 1013 ABGs from 120 CA patients with a median age of patients 66 years (interquartile range, 50-76). Median alpha-stat PaO2 changed from 122 (95-156) to 107 (82-143) mm Hg with pH-stat and median PaCO2 from 39 (34-46) to 35 (30-41) mm Hg (both P < .001). Using the categories of hyperoxemia, normoxemia, and hypoxemia, pH-stat estimation of PaO2 reclassified approximately 20% of patients. Using the categories of hypercapnia, normocapnia, and hypocapnia, pH stat estimation of PaCO2 reclassified approximately 40% of patients. The mortality of patients in different PaO2 and PaCO2 categories was similar for pH-stat and alpha-stat. CONCLUSIONS: Using the pH-stat method, fewer resuscitated CA patients admitted to intensive care unit were classified as hyperoxemic or hypercapnic compared with alpha-stat. These findings suggest an impact of ABG assessment methodology on PaO2, PaCO2 , and patient classification but not on associated outcomes.
Language eng
DOI 10.1016/j.jcrc.2014.09.022
Field of Research 1103 Clinical Sciences
1110 Nursing
Socio Economic Objective 920210 Nursing
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2015, Elsevier
Persistent URL http://hdl.handle.net/10536/DRO/DU:30080834

Document type: Journal Article
Collections: Faculty of Health
School of Nursing and Midwifery
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