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Oxygen and acid-base parameters of arterial and mixed venous blood, relevant versus redundant
Authors:O. SIGGAARD-ANDERSEN,I. H. Gø  THGEN
Affiliation:Department of Clinical Biochemistry, Herlev Hospital, and Department of Anaesthesia, Gentofte Hospital, University of Copenhagen, Denmark
Abstract:A complete pH and blood gas analysis of arterial and mixed venous blood may comprise more than forty different quantities. We have selected sixteen, including patient temperature. The arterial oxygen tension group includes the oxygen tension, fraction of oxygen in inspired air, and fraction of mixed venous blood in the arterial (total physiological veno-arterial shunting). The haemoglobin oxygen capacity group includes effective haemoglobin concentration and fractions of carboxy- and methaemoglobin. The haemoglobin oxygen affinity group includes half-saturation tension and estimated 2, 3-diphosphoglycerate concentration of erythrocytes. In a neonatal care unit fraction of fetal haemoglobin needs to be included. The arterial oxygen extractivity is measured as the oxygen extraction tension, which indicates the degree of compensation among the oxygen tension, capacity, and affinity. The mixed venous group includes mixed venous oxygen tension, and, when measured, cardiac output, and oxygen consumption rate. The acid-base status includes blood pH, arterial carbon dioxide tension, and extracellular base excess. Other quantities such as haemoglobin oxygen saturation, respiratory index, total oxygen concentration (oxygen content), oxygen extraction fraction, oxygen delivery, and several others, provide no essential additional clinical information and are therefore redundant.
Keywords:Acid-base status    blood gas analysis    carbon dioxide    intensive care    metabolic rate    mixed venous blood    pH
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