Abstract
Introduction: The routine and gold standard method to diagnose of acid – base disturbance is arterial blood gas (ABG) sampling. Capnography could be used to measure the end-tidal carbon dioxide (ETCO2) levels and ETco2 has a close correlation with the PaCo2. The aim of this study was comparison the ETco2 and arterial blood bicarbonate levels in patients with metabolic acidosis. Methods: In a descriptive-analytical study that performed in Emergency Department of Emam Reza Medical Research and Training Hospital of Tabriz on patients with metabolic acidosis, ETco2 level and blood bicarbonate levels in 262 patients were evaluated. Results: Mean of ETco2 and Hco3 levels in patients with metabolic acidosis were 22.29 ± 4.15 and 12.78 ± 3.83, respectively. In all patients, the significant direct linear relationship was found between ETco2 with Hco3 (r = 0.553, P < 0.001). We had 4 groups of patients with metabolic acidosis, also there is a significant direct linear relationship between the ETCo2 and the Hco3 level of arterial blood in patients with renal failure (P < 0.001 and r = 0.551), sepsis (P < 0.001 and r = 0.431), drug toxicity (P < 0.001 and r = 0.856), and ketoacidosis (DKA) (P < 0.001 and r = 0.559). Conclusion: According to the results of this study, capnography can be used for primary diagnosis of metabolic acidosis in spontaneously breathing patients who referred to the emergency wards, however, the ABG must be considered as the gold standard tool for diagnosis and guiding the treatment.
Highlights
The routine and gold standard method to diagnose of acid – base disturbance is arterial blood gas (ABG) sampling
Materials and Methods In the descriptive-analytic study that was conducted in the emergency department (ED) of Imam Reza Medical Research and Training Hospital, Tabriz, East Azerbaijan, Iran, 110 000 admission per year, during a year period (Jan 2014–Dec 2014) on the patients with metabolic acidosis referred to the ED, relationship of the ETCO2 values with arterial bicarbonate were evaluated
Inclusion criteria were all patients with suspected sepsis, acute gastroenteritis, renal failure, diabetic ketoacidosis (DKA) and other disorders with metabolic acidosis
Summary
The routine and gold standard method to diagnose of acid – base disturbance is arterial blood gas (ABG) sampling. Diagnosis and appropriate treatment of the acid-base disorder could be save the patient’s life.[1] The arterial blood gas (ABG) is used to evaluate the acid-base status and ABG sampling is an invasive and painful procedure for the patient, and this could lead to a delay in starting treatment by a physician This method sometimes causes the arterial wall spasm in some cases.[2] In physiological conditions, the body increases the minute ventilation to compensate for the metabolic acidosis, PaCO2 levels would be decreased.[3,4,5] Wave capnography in a noninvasive tool and indicate the amounts of expiratory CO2.6,7 The Capnography provides the accurate information in terms of the ventilation, perfusion and metabolic status from one breath to the next.[6,8] If the patient has a normal respiratory function, the difference between ETCO2 and PaCO2 was 2-5 mm Hg, and the amount of Paco[2] was greater than the ETCO2. These differences are caused by dead space in the respiratory system that does not participate in breathing.[6]
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