A discard volume of twice the deadspace ensures clinically accurate arterial blood gases and electrolytes and prevents unnecessary blood loss.


OBJECTIVE:To determine the blood discard volume, as a multiple of deadspace, that is required for accurate arterial blood gas and electrolyte testing from arterial catheters. DESIGN:Prospective, controlled, crossover trial. SETTING:Eighteen-bed intensive care unit of a metropolitan teaching hospital. PATIENTS:A total of 84 critically ill patients with a 20-gauge, radial arterial cannulae, pressure monitoring transducer set, and stable oxygenation. INTERVENTIONS:System deadspace (priming volume from sampling port to catheter tip) was established. Patients had six 0.5-mL arterial blood samples taken sequentially in random order using discard volumes of 1, 1.5, 2, 2.3, and 3.6 times the deadspace (experimental values) and 5.5 times the deadspace (control). MEASUREMENTS AND MAIN RESULTS:Samples were analyzed for Pao(2), Sao(2), pH, Paco(2), HCO(3)-, Na+, and K+. We performed repeated-measures analysis of variance with post hoc linear contrasts and compared mean experimental and control values. The smallest discard volumes that provided measurements that were statistically equal to control were twice the deadspace (Pao(2), p =.563; Sao(2), p =.371) and 3.6 times the deadspace (pH, p =.107; Paco(2), p=.519; HCO(3)-, p =.10). All discard volumes tested provided results that were statistically different from control for Na+ (p <.003) and K+ (p <.001). CONCLUSIONS:Many results were statistically different from control, although the actual discrepancies were very small. At clinically relevant levels of measurement, there was minimal variation between values obtained after a discard volume of twice the deadspace and control values. The level of error was clinically acceptable and within or close to the precision limits of the blood gas analyzer. Slight fluctuation in patient variables during sampling could also have contributed to the error. A blood discard volume of twice the deadspace is recommended for all variables. This will provide clinically accurate results and avoid the deleterious effects of unnecessary blood loss.


Crit Care Med


Critical care medicine


Rickard CM,Couchman BA,Schmidt SJ,Dank A,Purdie DM




Has Abstract


2003-06-01 00:00:00












  • Pulmonary capillary pressure during acute lung injury in dogs.

    abstract:OBJECTIVES:To measure pulmonary capillary pressure and pulmonary artery occlusion pressures both during control conditions and during acute lung injury and to evaluate the effects of inotropic therapy and volume loading on these measurements after lung injury. DESIGN:Prospective, randomized, controlled laboratory tria...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Pellett AA,Lord KC,Champagne MS,deBoisblanc BP,Johnson RW,Levitzky MG

    更新日期:2002-02-01 00:00:00

  • Targeted Inhibition of Leucine-Rich Repeat and Immunoglobulin Domain-Containing Protein 1 in Transplanted Neural Stem Cells Promotes Neuronal Differentiation and Functional Recovery in Rats Subjected to Spinal Cord Injury.

    abstract:OBJECTIVE:Leucine-rich repeat and immunoglobulin domain-containing protein (LINGO)-1 is expressed in neural stem cells, and its neutralization results in sustained neuronal immaturity. Thus, targeted inhibition of LINGO-1 via RNA interference may enhance transplanted neural stem cell survival and neuronal differentiati...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Chen N,Cen JS,Wang J,Qin G,Long L,Wang L,Wei F,Xiang Q,Deng DY,Wan Y

    更新日期:2016-03-01 00:00:00

  • Racial Differences in Palliative Care Use After Stroke in Majority-White, Minority-Serving, and Racially Integrated U.S. Hospitals.

    abstract:OBJECTIVES:Racial/ethnic differences in palliative care resource use after stroke have been recognized, but it is unclear whether patient or hospital characteristics drive this disparity. We sought to determine whether palliative care use after intracerebral hemorrhage and ischemic stroke differs between hospitals serv...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Faigle R,Ziai WC,Urrutia VC,Cooper LA,Gottesman RF

    更新日期:2017-12-01 00:00:00

  • Noninvasive ventilation in patients with acute hypercapnic exacerbation of chronic obstructive pulmonary disease who refused endotracheal intubation.

    abstract:OBJECTIVE:To determine the long-term outcome of noninvasive ventilation in chronic obstructive pulmonary disease patients who refused intubation for acute hypercapnic respiratory failure. DESIGN:Prospective, observational study. SETTING:Noninvasive ventilation unit in an acute regional hospital in Hong Kong. METHODS...

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    pub_type: 杂志文章


    authors: Chu CM,Chan VL,Wong IW,Leung WS,Lin AW,Cheung KF

    更新日期:2004-02-01 00:00:00

  • Ultrafilterable hypomagnesemia in neonates admitted to the neonatal intensive care unit.

    abstract:OBJECTIVE:To evaluate the frequency and clinical correlates of ultrafilterable hypomagnesemia in neonates admitted to the neonatal intensive care unit (ICU). DESIGN:Prospective, observational study. SETTING:Massachusetts General Hospital and Mount Auburn Hospital. PATIENTS:A total of 117 patients (84 neonatal ICU pa...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Munoz R,Khilnani P,Ziegler J,Salem M,Catlin EA,Nussbaum S,Todres ID,Chernow B

    更新日期:1994-05-01 00:00:00

  • Microvascular and systemic effects following top load administration of saturated carbon monoxide-saline solution.

    abstract:OBJECTIVE:To determine how top loads with different doses of carbon monoxide (CO)-saturated saline solutions (CO-saline) affect microvascular and systemic hemodynamics and to delineate the corresponding biochemical mechanisms. DESIGN:Prospective study. SETTING:University research laboratory. SUBJECTS:Male Golden Syr...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Hangai-Hoger N,Tsai AG,Cabrales P,Suematsu M,Intaglietta M

    更新日期:2007-04-01 00:00:00

  • 4-Aminopyridine, A Blocker of Voltage-Dependent K+ Channels, Restores Blood Pressure and Improves Survival in the Wistar Rat Model of Anaphylactic Shock.

    abstract:OBJECTIVES:Anaphylactic shock is associated with severe hypotension. Potassium channel blockers, such as 4-aminopyridine, induce vasoconstriction. The objective of this study was to test the ability of 4-aminopyridine to restore blood pressure and increase survival in anaphylactic shock. DESIGN:Experimental study. SE...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Bellou A,Al-Hammadi S,Aburawi EH,Dhanasekaran S,Nemmar A,Oulhaj A,Shafiuallah M,Zerrouki M,Yasin J,Bellou L,Alper SL,Bellou S,Kazzam E

    更新日期:2016-11-01 00:00:00

  • Mild hypothermia decreases arrhythmia susceptibility in a canine model of global myocardial ischemia*.

    abstract:OBJECTIVES:Although the majority of sudden cardiac arrests occur in patients with ischemic heart disease, the effect of therapeutic hypothermia on arrhythmia susceptibility during acute global ischemia is not well understood. While both ischemia and severe hypothermia are arrhythmogenic, patients undergoing therapeutic...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Piktel JS,Rosenbaum DS,Wilson LD

    更新日期:2012-11-01 00:00:00

  • Effectiveness Analysis of a Part-Time Rapid Response System During Operation Versus Nonoperation.

    abstract:OBJECTIVES:To evaluate the effect of a part-time rapid response system on the occurrence rate of cardiopulmonary arrest by comparing the times of rapid response system operation versus nonoperation. DESIGN:Retrospective cohort study. SETTING:A 1,360-bed tertiary care hospital. PATIENTS:Adult patients admitted to the...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Kim Y,Lee DS,Min H,Choi YY,Lee EY,Song I,Park JS,Cho YJ,Jo YH,Yoon HI,Lee JH,Lee CT,Do SH,Lee YJ

    更新日期:2017-06-01 00:00:00

  • Intestinal nitric oxide output during reduced mucosal blood flow in healthy volunteers.

    abstract:OBJECTIVE:Nitric oxide regulates epithelial permeability and other properties of the intestinal mucosal barrier. It previously has been shown in animals that intestinal mucosal nitric oxide production is impaired during gut hypoperfusion. The study was performed to confirm the presence of intestinal mucosal nitric oxid...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Snygg J,Aneman A,Pettersson A,Fändriks L

    更新日期:2003-08-01 00:00:00

  • Pulmonary hypertension in acute respiratory failure.

    abstract::In order to examine the prognostic value of pulmonary arterial hypertension (PAH) in patients with moderate and severe acute respiratory failure (ARF), 225 patients with ARF who had been treated with mechanical ventilation and admitted to our ICU during a 3-yr period (January, 1983 to January, 1986) were prospectively...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Villar J,Blazquez MA,Lubillo S,Quintana J,Manzano JL

    更新日期:1989-06-01 00:00:00

  • Value of human factors to medication and patient safety in the intensive care unit.

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    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Scanlon MC,Karsh BT

    更新日期:2010-06-01 00:00:00

  • Reactive hemophagocytic syndrome presenting as a component of multiple organ dysfunction syndrome.

    abstract:OBJECTIVE:To report two cases of severe reactive hemophagocytic syndrome (RHS), to discuss their impact, and to present evidence that RHS may be a constitutive part of multiple organ dysfunction syndrome (MODS). DESIGN:Case-report. SETTING:Pediatric intensive care unit (PICU). PATIENTS:Two patients with RHS and MODS...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Gauvin F,Toledano B,Champagne J,Lacroix J

    更新日期:2000-09-01 00:00:00

  • Associations between intramucosal acidosis in the gut and organ failure.

    abstract:OBJECTIVE:To alert health professionals to the need for early detection and prevention of shock in critically ill patients. By describing the associations between intramucosal acidosis in the gut and multiple system organ failure, the author demonstrates how noninvasive measurement of gut intramucosal pH can be used to...

    journal_title:Critical care medicine

    pub_type: 杂志文章,评审


    authors: Fiddian-Green RG

    更新日期:1993-02-01 00:00:00

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    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Eisendrath SJ,Link N,Matthay M

    更新日期:1986-02-01 00:00:00

  • Cytochrome P450 3A4 activity after surgical stress.

    abstract:OBJECTIVE:To evaluate the relationship between the acute inflammatory response after surgical trauma and changes in hepatic cytochrome P450 3A4 activity, compare changes in cytochrome P450 3A4 activity after procedures with varying degrees of surgical stress, and to explore the time course of any potential drug-cytokin...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Haas CE,Kaufman DC,Jones CE,Burstein AH,Reiss W

    更新日期:2003-05-01 00:00:00

  • Chlorpromazine treatment for neurogenic pulmonary edema.

    abstract::A patient with neurogenic pulmonary edema was successfully treated with the alpha-blocking agent, chlorpromazine. A pathophysiologic basis for this drug's efficacy is discussed. ...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Wohns RN,Tamas L,Pierce KR,Howe JF

    更新日期:1985-03-01 00:00:00

  • Better infrastructure for critical care trials: nomenclature, etymology, and informatics.

    abstract:OBJECTIVE:The goals of this review article are to review the importance and value of standardized definitions in clinical research, as well as to propose the necessary tools and infrastructure needed to advance nosology and medial taxonomy to improve the quality of clinical trials in the field of critical care. DATA S...

    journal_title:Critical care medicine

    pub_type: 杂志文章,评审


    authors: Singh JM,Ferguson ND

    更新日期:2009-01-01 00:00:00

  • Effects of diltiazem on oxygen delivery and consumption after asphyxial cardiac arrest and resuscitation.

    abstract:BACKGROUND AND METHODS:Calcium-channel blockers may attenuate vasospasm after transient ischemia and improve organ blood flow after resuscitation. Our aim was to assess the effect of diltiazem on systemic oxygen delivery and consumption, hemodynamics, electroencephalogram (EEG), and organ blood flow after restoration o...

    journal_title:Critical care medicine

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Lindner KH,Prengel AW,Ahnefeld FW,Ensinger H,Schürmann W

    更新日期:1992-05-01 00:00:00

  • Functional Status Score for the ICU: An International Clinimetric Analysis of Validity, Responsiveness, and Minimal Important Difference.

    abstract:OBJECTIVES:To evaluate the internal consistency, validity, responsiveness, and minimal important difference of the Functional Status Score for the ICU, a physical function measure designed for the ICU. DESIGN:Clinimetric analysis. SETTINGS:Five international datasets from the United States, Australia, and Brazil. PA...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Huang M,Chan KS,Zanni JM,Parry SM,Neto SG,Neto JA,da Silva VZ,Kho ME,Needham DM

    更新日期:2016-12-01 00:00:00

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    abstract::With the thermodilution technique, repeated determination of cardiac index (CI) has become a rapid, easily accomplished, safe procedure. We paired 77 CI determinations measured by direct Fick and thermodilution techniques in 21 patients who underwent myocardial revascularization. Commercially available thermistor-tipp...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Hodges M,Downs JB,Mitchell LA

    更新日期:1975-09-01 00:00:00

  • Real-Time Risk Prediction on the Wards: A Feasibility Study.

    abstract:OBJECTIVE:Failure to detect clinical deterioration in the hospital is common and associated with poor patient outcomes and increased healthcare costs. Our objective was to evaluate the feasibility and accuracy of real-time risk stratification using the electronic Cardiac Arrest Risk Triage score, an electronic health r...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Kang MA,Churpek MM,Zadravecz FJ,Adhikari R,Twu NM,Edelson DP

    更新日期:2016-08-01 00:00:00

  • Timing and predictors of death in pediatric patients with multiple organ system failure.

    abstract:OBJECTIVES:To describe the timing of onset of organ system failure, multiple organ system failure diagnosis, and the subsequent death in children admitted to a pediatric intensive care unit (ICU). Second, to identify independent risk markers of death in pediatric patients with multiple organ system failure. DESIGN:Rev...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Proulx F,Gauthier M,Nadeau D,Lacroix J,Farrell CA

    更新日期:1994-06-01 00:00:00

  • Insulin reduces the multiple organ injury and dysfunction caused by coadministration of lipopolysaccharide and peptidoglycan independently of blood glucose: role of glycogen synthase kinase-3beta inhibition.

    abstract:OBJECTIVE:Insulin reduces morbidity and mortality among critically ill patients, but the molecular mechanisms of its effect remain unknown. Insulin is a well-known inhibitor of glycogen synthase kinase-3, which may play an important role in systemic inflammation and shock. Here we investigate the role of blood glucose ...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Dugo L,Collin M,Allen DA,Murch O,Foster SJ,Yaqoob MM,Thiemermann C

    更新日期:2006-05-01 00:00:00

  • Assessment of the development of choked flow during total liquid ventilation.

    abstract:OBJECTIVE:The flow rate of a liquid drainage from the lungs is limited because of the elastic nature of the airways. This study was designed to clarify the relationship between intrapulmonary liquid volume and the development of the flow limitation or choked flow phenomenon as a function of expiratory flow rate during ...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Baba Y,Brant D,Brah SS,Grotberg J,Bartlett RH,Hirschl RB

    更新日期:2004-01-01 00:00:00

  • Selective decontamination of the digestive tract: impact on cytokine release and mucosal damage after hemorrhagic shock.

    abstract:OBJECTIVE:To determine if selective decontamination of the digestive tract (SDD) influences the proinflammatory immune response of the gut after hemorrhage. DESIGN:Random assignment to either unmanipulated control after 7 days of SDD or conventional rat chow, or hemorrhagic shock group after the same time of conventio...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Kahlke V,Fändrich F,Brötzmann K,Zabel P,Schröder J

    更新日期:2002-06-01 00:00:00

  • Critical Care Bed Capacity in Asian Countries and Regions.

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    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Phua J,Faruq MO,Kulkarni AP,Redjeki IS,Detleuxay K,Mendsaikhan N,Sann KK,Shrestha BR,Hashmi M,Palo JEM,Haniffa R,Wang C,Hashemian SMR,Konkayev A,Mat Nor MB,Patjanasoontorn B,Nafees KMK,Ling L,Nishimura M,Al Bahrani

    更新日期:2020-05-01 00:00:00

  • Choosing Wisely in Critical Care: Results of a National Survey From the Critical Care Societies Collaborative.

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    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Kleinpell R,Sessler CN,Wiencek C,Moss M

    更新日期:2019-03-01 00:00:00

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    journal_title:Critical care medicine

    pub_type: 杂志文章,评审


    authors: Christians ES,Yan LJ,Benjamin IJ

    更新日期:2002-01-01 00:00:00

  • Effect of different cycling-off criteria and positive end-expiratory pressure during pressure support ventilation in patients with chronic obstructive pulmonary disease.

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    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Chiumello D,Polli F,Tallarini F,Chierichetti M,Motta G,Azzari S,Colombo R,Rech R,Pelosi P,Raimondi F,Gattinoni L

    更新日期:2007-11-01 00:00:00