Arterial Sampler Filling Time During Arterial and Venous Punctures, and Its Relationship with Mean Arterial Pressure in Human Subjects

Abstract

When obtaining an arterial blood sample via percutaneous puncture, there is a risk of accidentally obtaining venous blood. Conventional methods of confirming arterial blood at the bedside, such as blood color and pulsatile return, can be misleading in patients with low blood pressure or hypoxemia. To determine if the arterial sampler filling time can be an accurate indicator of obtaining an arterial blood sample in subjects with various blood pressures. Our hypotheses were that there would be a statistically significant negative correlation between sampler filling time during arterial puncture and mean arterial blood pressure, and a statistically significant difference between venous and arterial filling times in human adults. Prior to an arterial puncture, we measured and recorded arterial blood pressure noninvasively. During the arterial and venipuncture procedures we measured the amount of time it took to fill the sampler and the volume of blood obtained. A t test for independent samples was calculated to determine if mean arterial sampler filling times were significantly different between the arterial and venous groups. Pearson correlation coefficient was calculated to determine the relationship between mean arterial pressure and seconds of filling time per milliliter in the arterial group. This study included 38 human subjects; 22 were adult patients ordered for arterial blood gases by arterial puncture; 16 were normal, healthy, adult volunteers who had a venipuncture performed using an arterial blood sampler. The mean ± SD filling time was 15 ± 4 s/mL for the arterial group and 115 ± 48 s/mL for the venous group, and the difference was significant (P < .001). The range of mean arterial pressures was 69-125 mm Hg; the average mean arterial pressure was 91 ± 13 mm Hg, and the Pearson correlation coefficient for mean arterial pressures and sampler filling times was -0.49 (P = .02). Our results were consistent with a laboratory study showing a significant difference between arterial and venous filling times and a negative correlation between mean arterial pressure and sampler filling time, but our times in adult subjects were longer. Respiratory therapists may find arterial sampler filling time as a useful indicator of successful arterial puncture at the bedside.