Abstract:
In the absence of an indwelling arterial catheter, capillary blood gas sampling may be used to evaluate the acid/base and ventilation status of neonatal and pediatric patients with cardiorespiratory conditions. These guidelines were developed from a comprehensive review of the literature to provide guidance for the collection, handling, and interpretation of blood obtained from an arterialized capillary sample. Capillary and venous blood gas measurements are a useful alternative to arterial blood gas measurements for neonatal and pediatric patients who do not require close monitoring of [Formula: see text] In the presence of alterations in body temperature, blood pressure, or peripheral perfusion, agreement between a capillary blood gas with an arterial sample is recommended to determine whether changes in these physiologic conditions reduce reliability. Perfusion to the sample site should be assessed and preference given to blood sampling from a well perfused site, and blood should be analyzed within 15 min of sampling to minimize the propensity for pre-analytical errors. Clinicians should consider re-collecting a blood sample, obtained from an artery, vein, or capillary, when the blood gas or analyte result interpretation does not align with the patient\'s clinical presentation. A pneumatic tube system can be reliably used to transport blood gas samples collected in a syringe and capillary tube to a clinical laboratory for analysis. To reduce the cumulative pain effect and risk of complications, the capillary puncture procedure should be minimized when possible. Non-pharmacologic interventions should be used to reduce pain associated with capillary blood gas sampling. Automatic lancets are preferred to puncture the skin for capillary blood gas collection.
摘要:
在没有留置动脉导管的情况下,毛细血管血气采样可用于评估患有心肺疾病的新生儿和儿科患者的酸/碱和通气状态。这些指南是根据对文献的全面审查而制定的,目的是为收集提供指导,处理,并解释从动脉化毛细血管样品中获得的血液。对于不需要密切监测[公式:见正文]的新生儿和儿科患者,毛细管和静脉血气测量是动脉血气测量的有用替代方法。血压,或外周灌注,建议在毛细血管血气与动脉样本之间达成一致,以确定这些生理条件的变化是否会降低可靠性。应评估样品部位的灌注,并优先考虑从灌注良好的部位进行血液采样。和血液应在采样后15分钟内进行分析,以最大程度地减少分析前错误的倾向。临床医生应该考虑重新采集血液样本,从动脉获得,静脉,或毛细管,当血气或分析物结果解释与患者的临床表现不一致时。气动管系统可以可靠地用于将注射器和毛细管中收集的血液气体样品运输到临床实验室进行分析。为了减少累积疼痛效应和并发症的风险,在可能的情况下,毛细管穿刺程序应尽量减少。非药物干预应用于减少与毛细血管血气采样相关的疼痛。自动刺血针优选用于穿刺皮肤以收集毛细血管血液气体。