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- Clinical applications of blood gas analysis: a comparative review of arterial and venous blood gas monitoring in critical care
- Gyeo Ra Lee
- Acute Crit Care. 2025;40(2):153-159. Published online May 30, 2025
- DOI: https://doi.org/10.4266/acc.000900
- 42,419 View
- 1,508 Download
- 13 Web of Science
- 14 Crossref
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Abstract
PDF - Blood gas analysis is an essential diagnostic tool used for assessing acid-base balance, ventilation, and oxygenation in critically ill patients. Arterial blood gas analysis (ABGA) remains the gold standard, primarily due to its accuracy in measuring oxygenation. Venous blood gas analysis (VBGA), in contrast, serves as a less invasive alternative and is particularly useful for evaluating acid-base status and metabolic function. Important parameters such as oxygen saturation of central venous blood (ScvO₂) and venous-to-arterial carbon dioxide pressure difference (∆pv-aCO₂) provide critical insights into hemodynamic status, cardiac output, and tissue perfusion. Although VBGA cannot replace ABGA for the precise assessment of oxygenation, it remains a valuable tool in clinical scenarios involving hemodynamic monitoring, shock management, and critical care decision-making.
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Citations
Citations to this article as recorded by
- Reference intervals for venous blood gas measurement in a healthy Chinese population
Sheng Jiang, Qian Zhao, Hua Wang, Min Li, Yuanzhu Ou, Weiwei Lin
Clinica Chimica Acta.2027; 592: 121212. CrossRef - Ultrasound guidance versus conventional technique for radial arterial puncture in patients with shock in the emergency department: a randomized controlled trial
Durmus Ali Ersahin, Ismail Erkan Aydin, Tugce Ersahin, Nalan Kozaci
BMC Emergency Medicine.2026;[Epub] CrossRef - Central venous oxygen saturation vs. oxygen extraction ratio in septic shock resuscitation: Which metric is more informative?
Athanasios Chalkias, Konstantina Katsifa, Stavroula Amanetopoulou, Aikaterini Nodarou, Petros Lampropoulos, Ioannis Thiveos, Konstantinos Sakellaridis, Varvara Grammatikopoulou, Athanasios Prekates, Paraskevi Tselioti
Anesthesiology and Perioperative Science.2026;[Epub] CrossRef - Beyond blood pressure: a comprehensive overview of clinical indices in shock and tissue hypoperfusion
Jooyun Kim, Saeyeon Kim, Ji-Hee Lee, Sua Kim
Acute and Critical Care.2026; 41(2): 201. CrossRef - Impacts of inspired oxygen concentration and arterial oxygen tension on venous and tissue oxygen saturation
Kwok Ming Ho
Acute and Critical Care.2026; 41(2): 436. CrossRef - Closing the Gap: Central Venous-to-Paco 2 Difference in Pediatric Shock
Michelle Adu-Darko
Pediatric Critical Care Medicine.2026; 27(7): 899. CrossRef - A population-adaptive decision-support method for ventilator parameter optimization
Xianhui Lian, Tianliang Hu, Songhua Ma, Dedong Ma
Knowledge-Based Systems.2026; 349: 116490. CrossRef - Vertical Displacement Index and Early Treatment-Related Physiological Improvement in Acute Respiratory Failure: An Exploratory Ultrasound-Based Study
Bedriye Müge Sönmez, İlker Şirin, Gülşen Akçay, Murat Özdemir, Necip Gökhan Güner
Advances in Respiratory Medicine.2026; 94(3): 40. CrossRef - Patient characteristics, vital signs and tcpCO2 dynamics significantly influence tcpCO2 accuracy in extremely preterm infants: an observational study
Lena Olivier, Camelia Lauterbach Oprea, André Stollenwerk, Valerie Pfannschmidt, Thorsten Orlikowsky, Mark Schoberer
Frontiers in Pediatrics.2026;[Epub] CrossRef - Essential Data Elements for Laboratory Test Interoperability: An Expert Consensus-Based Framework
Ha Nui Kim, Min-Sun Kim, Sollip Kim, Kuenyoul Park, Eun-Jung Cho, Hyejin Ryu, YeJin Oh, Shinae Yu, John Hoon Rim, Sang-Mi Kim, Geon Park, Jaehyeon Lee, Hyun-Seung Lee, Hyun-Woo Choi, You Kyoung Lee, Jeong Hwan Shin, Sang-Guk Lee, Young Kyung Lee, Jeong-Ye
Annals of Laboratory Medicine.2026; 46(5): 507. CrossRef - Ventilatory compensation for metabolic acidosis is independent of hypertension in dogs with chronic kidney disease
Letícia da Silva Rueda, André Leal Raymundo Pessina, Igor Luiz Salardani Senhorello, Rodrigo Prevedello Franco, Paulo Sérgio Patto dos Santos, Maria Vitoria Magalhães Dias, Lucas Ferreira Gomes, Wagner Luis Ferreira
Veterinary Record.2026;[Epub] CrossRef - Assessing and Enhancing the Interpretation Quality of Arterial Blood Gas Among Junior Doctors
Abubakr Muhammed, Mohaned Altijani Abdalgadir Hamdnaalla, Fakher Aldeen Raft Fakher Aldeen Noman, Ahmed Altayeb Abbas Fadlallah, Mohammed Ali Mohammed Ali, Hanaa Ahmed Khalifa Elamin, Hala Aamir Abdelraouf Ahmed , Ameer Abdallatif Saeed Elkhazin, Hala Ome
Cureus.2025;[Epub] CrossRef - Using zlog in spider charts for fast diagnosis recognition
Johannes Böhm, Johannes Daubitzer, Thorsten M. Smul, Lisa-Maria Meier, Sven Schneider
Journal of Laboratory Medicine.2025; 49(6): 268. CrossRef - Predictive performance of central venous oxygen saturation, lactate, base excess, and alactic base excess for intradialytic hypotension
Angelica J. Luevanos-Aguilera
BMC Nephrology.2025;[Epub] CrossRef
- Reference intervals for venous blood gas measurement in a healthy Chinese population
Original Articles
- Blood Gases during Cardiopulmonary Resuscitation in Predicting Arrest Cause between Primary Cardiac Arrest and Asphyxial Arrest
- Sei Jong Bae, Byung Kook Lee, Ki Tae Kim, Kyung Woon Jeung, Hyoung Youn Lee, Yong Hun Jung, Geo Sung Lee, Sun Pyo Kim, Seung Joon Lee
- Korean J Crit Care Med. 2013;28(1):33-40.
- DOI: https://doi.org/10.4266/kjccm.2013.28.1.33
- 5,117 View
- 37 Download
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Abstract
PDF
- BACKGROUND
If acid-base status and electrolytes on blood gases during cardiopulmonary resuscitation (CPR) differ between the arrest causes, this difference may aid in differentiating the arrest cause. We sought to assess the ability of blood gases during CPR to predict the arrest cause between primary cardiac arrest and asphyxial arrest.
METHODS
A retrospective study was conducted on adult out-of-hospital cardiac arrest patients for whom blood gas analysis was performed during CPR on emergency department arrival. Patients were divided into two groups according to the arrest cause: a primary cardiac arrest group and an asphyxial arrest group. Acid-base status and electrolytes during CPR were compared between the two groups.
RESULTS
Presumed arterial samples showed higher potassium in the asphyxial arrest group (p < 0.001). On the other hand, presumed venous samples showed higher potassium (p = 0.001) and PCO2 (p < 0.001) and lower pH (p = 0.008) and oxygen saturation (p = 0.01) in the asphyxial arrest group. Multiple logistic regression analyses revealed that arterial potassium (OR 5.207, 95% CI 1.430-18.964, p = 0.012) and venous PCO2 (OR 1.049, 95% CI 1.021-1.078, p < 0.001) were independent predictors of asphyxial arrest. Receiver operating characteristic curve analyses indicated an optimal cut-off value for arterial potassium of 6.1 mEq/L (sensitivity 100% and specificity 86.4%) and for venous PCO2 of 70.9 mmHg (sensitivity 84.6% and specificity 65.9%).
CONCLUSIONS
The present study indicates that blood gases during CPR can be used to predict the arrest cause. These findings should be confirmed through further studies.
- Relationship between the Changes of Arterial Blood Gas by Positioning from Prone to Supine and Patients' Survival in ARDS
- Mi Young Kim, Sang Bum Hong, Chae Man Lim, Younsuck Koh
- Korean J Crit Care Med. 2007;22(2):71-76.
- 4,122 View
- 67 Download
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Abstract
PDF
- BACKGROUND
Prone positioning has been adopted as a strategy to improve oxygenation in patients with refractory acute respiratory distress syndrome (ARDS). After returning to supine position, most of patients show arterial blood gas changes. However, the clinical implications have not been elucidated. This study was aimed to observe the relationship between the arterial blood gas changes followed by changing position from prone to supine and survival of ARDS.
METHODS
We analyzed medical data of 53 ARDS patients, who showed improved arterial oxygenation (defined as the increase in PaO2/FiO2 by > or =20 mmHg within 8~12 hour after prone positioning) in a medical intensive care unit from January, 2000 to July, 2006. The patients were returned to supine position when they showed their PaO2/FiO2 > or =150 mmHg. We compared the arterial blood gas changes between the survivor and the nonsurvivor.
RESULTS
The survivor has significant pH improvement after position change (the survivor 0.01+/-0.06 vs. the nonsurvivor -0.03+/-0.08; p=.03). The PaO2/FiO2 and FiO2 changes were not different between the survivor (14.44 +/-69.68 and -2.2+/-4.3, respectively) and the nonsurvivor (-7.17+/-83.94 and 1.8+/-6.0, respectively; p=.314 and .843). The patients whose PaO2/FiO2 were deteriorated had higher mortality without statistical significance (p=.305). The PaCO2 changes were not different between two groups (-0.05+/-11.46 vs. 3.47+/-17.62, p=.390).
CONCLUSIONS
The early changes in pH differed significantly between the survivor and the nonsurvivor after returning patients to supine position from prone. Whether this marker can be a predictor of survival should be studied further.
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