‘’TO COMPARE DIFFERENT PARAMETER OF ABG AND VBG IN PATIENTS WITH KETOACIDOSIS CASES OF DIABETES’’

Abstract

Introduction- Diabetes mellitus is common endocrinopathy. It is a group of common metabolic disorder which share the phenotype of hyperglycemia. DKA is acute, severe disorder directly related to diabetes. DKA was formerly considered a hallmark of type 1 DM, but it also occurs in individuals with type 2 DM who can sometimes subsequently be treated with oral glucose-lowering agents. Performing a VBG rather than an ABG is particularly convenient in the ICU and in the emergency department, either peripherally or from a central venous line from which venous blood can be quickly drawn.

Aims and objectives- This is a prospective study, was conducted in Department of General Medicine, G.R. Medical College, Gwalior (M.P.) from Jan 2021 – Jun 2022. The main aim of the study is-

‘’To compare different parameter of ABG and VBG in patients with ketoacidosis cases of diabetes’’.

Methods and materials- This is a single center observational study. In this study, demographic, clinical and laboratory details were studied in patients presenting with diabetic ketoacidosis satisfying the study population criteria and the impact on the outcome was assessed. 96 patients who will be getting admitted in medical units at Jayarogya hospital and group were randomly selected as per the inclusion and exclusion criteria. Written informed consent will be obtained from each diabetic patients enrolled in the study.

All the dates will be entered in a data collection sheet in an Excel format and analysed using SPSS Software. Numerical values will be reported using mean and standard deviation or median. Categorical values will be reported using number and percentages. Probability value (p) value less than 0.05 was considered a statistically significant.

Results- Among the studied 97 patients, maximum cases belonged to the age group 41-60 years (n=34). Mean age of the study population was 40.53 years with standard deviation of 17.47 years. Out of studied 97 patients, 70 were male and 27 were female. In our study, most common clinical symptom was vomiting (found in 28.9% patients), followed by altered sensorium (24.7% each), while abdominal pain 22.7% and shortness of breath was found in 17.5 % patients respectively. Among the studied 97 patients,16 were having associated hypertension and 4 patients were having CAD, while only 2 patients were suffering from hypothyroidism. In our study, Type 1 DM patients were 43.3% while 56.7% were Type 2 DM. Among the patients 41.2% shown no ECG changes, while 50.5% shown sinus tachycardia and only 8.2% shown significant ECG changes with tall T waves in precordial leads. Among the studied 97 patients, 19.6% expired while 80.4% recovered. The mean value of Arterial pH is 7.24±0.07 and Arterial bicarbonates is 18.74±2.73. while mean Venous pH is 7.26±0.06 and Venous Bicarbonates is 19.58±2.67 in expired patients.

The mean value of Arterial pH is 7.25±0.07 and Arterial bicarbonates is 17.07±3.06 while mean Venous pH is 7.25±0.06 and Venous Bicarbonates is 18.07±3.04 in expired patients.

Conclusions- It was concluded that venous blood gas analysis has got advantages over arterial blood gas analysis like safety, fewer number of punctures, easy sampling, less painful, less invasive even though there are some reservations’ analysis safer alternative to ABG for determining acid base status reducing the need for frequent invasive arterial sampling.

This study suggests that VBG pH values very closely correlate with ABG pH values, which also shows VBG substitution for ABG.

Hence venous blood gas might be used as an ideal alternative to arterial blood gas in the initial management of patients in Diabetic Ketoacidosis.