Rant #5 Please don't tell me what the PaO2 is...
Less experienced critical care staff members are frequently exercised by arterial blood gas PaO2 readings.
What is the SpO2 I genially ask? In our target range? Well that's fine then.
Staff member shifting uneasily, "but the PaO2..."
Here we go...
Less experienced critical care staff members are frequently exercised by arterial blood gas PaO2 readings.
What is the SpO2 I genially ask? In our target range? Well that's fine then.
Staff member shifting uneasily, "but the PaO2..."
Here we go...
Reposted from
Ben Morton
Over the years I've developed a number of "rants" (aka teaching) that seem to resonate with trainees on #ICUsky ward round.
This pedogogical style might make educationalists wince but keeps me and (crucially) trainees, interested
Interested in any counter rants, refined rants or rant affirmation
This pedogogical style might make educationalists wince but keeps me and (crucially) trainees, interested
Interested in any counter rants, refined rants or rant affirmation
Comments
Why aren’t they correlating? Which one do we trust and why?
More work needs to be done to ensure accurate SpO2 readings for all individuals.
@iwashyna.bsky.social @ashfawzy.bsky.social
https://pubmed.ncbi.nlm.nih.gov/33326721/
This link gives a nice overview
https://emcrit.org/pulmcrit/pulse-oximetry/
I ask trainees what would happen to their PaO2 if they hold their breath for a minute...
https://journal.chestnet.org/article/S0012-3692(15)46490-6/abstract
Would a VBG and SpO2 not suffice?
I've got a real soft spot for this study comparing VBG and ABG in patients with COPD:
https://thorax.bmj.com/content/71/3/210
We talk about correlation between ABG and VBG and how the only real difference is PaO2
https://litfl.com/vbg-versus-abg/
Well for me (working in a non-cardiac unit) the most common reason would be to calculate the PaO2/FiO2 ratio.
But even for this, there is some nice work showing that SpO2/FiO2 can be used to impute this calculation...
https://pubmed.ncbi.nlm.nih.gov/19242333/
I don't think there is justification to do an arterial stab for an ABG if the critical care patient does not have an arterial line (for another reason), VBG is much more comfortable for the patient and provides adequate information.
Think before you tell me the PaO2....
https://bsky.app/profile/iainmoppett.bsky.social/post/3lbtjmci7ys2g
To the excellent article I would add that SpO2 is a much more significant determinant of blood oxygen content than PaO2.
An ABG only estimates this whilst a pulse oximeter measures it. Which would you rather know?