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Emergency Department Blood Gas Utilization and Changes in Ventilator Settings.
- Source :
- Respiratory Care; Jan2018, Vol. 63 Issue 1, p36-42, 7p, 1 Diagram, 3 Charts
- Publication Year :
- 2018
-
Abstract
- BACKGROUND: Mechanically ventilated patients increasingly spend hours in emergency department beds before ICU admission. This study evaluated the performance of blood gases in mechanically ventilated subjects in the emergency department and subsequent changes to mechanical ventilation settings. METHODS: This was a multi-center, prospective, observational study of subjects ventilated in the emergency department, conducted at 3 academic emergency departments from July 2011 to March 2013. We measured the rate of arterial blood gas (ABG) and venous blood gas (VBG) analysis, and we assessed the associations between the conditions of hypoxemia, hyperoxia, hypercapnia, or acidemia and changes to mechanical ventilator settings. RESULTS: Of 292 ventilated subjects, 17.1% did not have a blood gas sent in the emergency department. Ventilator changes were made significantly more frequently for subjects who had an ABG as the initial blood gas sent in the emergency department (odds ratio 2.70, 95% CI 1.46-4.99, P = .002). However, findings of hypoxemia, hyperoxia, hypercapnia, or acidemia were not correlated with ventilator adjustments. CONCLUSIONS: In this prospective observational study of subjects mechanically ventilated in the emergency department, the majority had a blood gas checked while in the emergency department. While ABGs were associated with having changes made to ventilator settings in the emergency department, clinical findings of hypoxemia, hyperoxia, hypercapnia, and acidemia were not. Inattention to blood gas results may lead to missed opportunities in guiding ventilator changes in the emergency department. [ABSTRACT FROM AUTHOR]
- Subjects :
- HYPOXEMIA
HYPERCAPNIA
HYPEROXIA
ACADEMIC medical centers
ARTIFICIAL respiration
BLOOD gases analysis
CONFIDENCE intervals
HOSPITAL emergency services
LONGITUDINAL method
MEDICAL cooperation
SCIENTIFIC observation
PROBABILITY theory
RESEARCH
DECISION making in clinical medicine
LOGISTIC regression analysis
CONTINUING education units
DATA analysis software
DESCRIPTIVE statistics
ODDS ratio
MANN Whitney U Test
THERAPEUTICS
Subjects
Details
- Language :
- English
- ISSN :
- 00201324
- Volume :
- 63
- Issue :
- 1
- Database :
- Supplemental Index
- Journal :
- Respiratory Care
- Publication Type :
- Academic Journal
- Accession number :
- 126845369
- Full Text :
- https://doi.org/10.4187/respcare.05590