TO STUDY ARTERIAL BLOOD GAS AND VENOUS BLOOD GAS PARAMETERS AND ITS CORRELATION WITH COMPLICATIONS AND TREATMENT OUTCOME IN PATIENTS WITH KETOACIDOSIS CASES OF DIABETES.

Abstract

Introduction- 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- The main aim of the study is- To study arterial blood gas and venous blood gas parameters and its correlation with complications and treatment outcome in patients with ketoacidosis cases of diabetes.

Methods and materials- This is a single center observational study was conducted in Department of General Medicine and department of anesthesiology, District Hospital, Bemetara (C.G.) from Jan 2022 – Jun 2024 in 96 patients. 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. 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, 70 were male and 27 were female. Mean age of the study population was 40.53 years with standard deviation of 17.47 years. Most common clinical symptom was vomiting (found in 28.9% patients), followed by altered sensorium (24.7% each). 16 were having associated hypertension and 4 patients were having CAD, while only 2 patients were suffering from hypothyroidism. Type 1 DM patients were 43.3% while 56.7% were Type 2 DM. No any ECG changes, while 50.5% shown sinus tachycardia and only 8.2% shown significant ECG changes with tall T waves in precordial leads. 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- 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. 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.