Limited value of early endoscopy in the management of acute upper gastrointestinal bleeding: Am J Surg 140:284–290 (Aug) 1980
✍ Scribed by Sandra Greco
- Book ID
- 104311955
- Publisher
- Elsevier Science
- Year
- 1981
- Tongue
- English
- Weight
- 272 KB
- Volume
- 10
- Category
- Article
- ISSN
- 1097-6760
No coin nor oath required. For personal study only.
✦ Synopsis
Arterial blood gases are frequently an essential tool in the evaluation of the acutely ill patient. In order to test the accuracy of values obtained by inaccurate technique and by alternative anticoagulants, arterial blood gases were collected in tubes prepared with either dead-space (tube coating) or dead-space and 0.5 cc of one of six solutions: heparin 1,000, 5,000, or 25,000 IU/ml, EDTA, trisodium citrate, or Heller-Paul oxalate. When evaluating ABGs that contain deadspace anticoagulant and blood, only heparin 1,000 and 5,000, citrate, and oxalate gave results that were within the accuracy of the machine. When 0.5 cc of these anticoagulants was added, all demonstrated a significant fall in PCOe (9% to 17.5%) and in calculated HCO3 (11% to 22%). Accurate blood gas determinations and therapeutic response depend on accurate technique. (Editor's note: A common misconception is that excess heparin lowers the pH. This study demonstrates that pH is independent of the heparin concentrations used in clinical practice.