Indication-Based Guideline for Arterial Blood Gas Analysis after Cardiac Surgery
Pranee Tongsai RN, MSc*, Sirilak Suksompong MD, MSc**, Suntaraporn Nicrotha BNS**, Narisa Ajonsre RN**, Wanchai Wongkornrat MD***, Benno von Bormann MD**
Affiliation : * Cardiovascular Surgical Intensive Care Unit, Division of Nursing, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand ** Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand *** Division of Cardiothoracic Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Objective : To determine whether an indication-based guideline can decrease the use of arterial blood gas (ABG) tests in
cardio-surgical patients.
Material and Method: This before and after study was conducted in a university-based national tertiary referral hospital.
Postoperative patient age more than 18 years who were admitted to the cardiac intensive care unit were included. Seventy
patients were randomly selected during January 2013 to September 2013 and data were retrospectively collected and
recorded as a control group (Group C). Another seventy patients were prospectively investigated during January 2015 to
May 2015 and served as a guideline group (Group G). Whereas patients in Group C were subjected to ABG testing every four
hours, Group G patients received ABG testing according to the protocol set forth in a newly developed indication-based
guideline for arterial blood gas analysis.
Results : There were no statistically significant differences in demographic and perioperative data between groups. The
median number of ABG tests per patient was 8 (range 4 to 47) in Group C and 4 (range 2 to 15) in Group G (p<0.01). There
were no significant differences between groups for postoperative course, morbidity, or mortality.
Conclusion : The indication-based guideline for arterial blood gas analysis significantly reduced the number of ABG tests in
postoperative cardiac ICU patients without adversely affecting patient outcomes. Accordingly and based on these findings,
this ABG test guideline should be implemented in daily clinical practice.
Keywords : Blood gas analysis, Intensive care unit, Cardiac surgery patient
