25 Questions
Which type of blood gas measurement is recommended as an alternative to arterial blood gas for neonatal and pediatric patients who do not require close monitoring of PaO2?
Capillary blood gas measurements
In the absence of an indwelling arterial catheter, what type of blood gas sampling may be used to evaluate the acid/base and ventilation status of neonatal and pediatric patients with cardiorespiratory conditions?
Capillary blood gas sampling
When is agreement between a capillary blood gas and an arterial sample recommended?
In the presence of alterations in body temperature, blood pressure, or peripheral perfusion
What is the primary focus of the AARC Clinical Practice Guidelines related to blood gas sampling for neonatal and pediatric patients?
Collection, handling, and interpretation of arterialized capillary blood samples
What are capillary and venous blood gas measurements considered to be for patients who do not require close monitoring of PaO2?
Useful alternatives to arterial blood gas measurements
Which blood gas sampling method is described as less technically challenging and carrying fewer risks of harm?
Capillary blood sampling
Where is the preferred site for collecting capillary blood in infants and small children?
Posterolateral aspect of the foot
What can reduce the reliability of capillary blood gas and pH results?
All of the above
What contributes to pre-analytical errors and interferes with effective medical management?
Poor-quality samples
How did the committee for developing the guidelines primarily communicate?
Face-to-face meetings and frequent email communications
Which blood gas sampling method shows good agreement for measurement of pH and PCO2?
Arterial and capillary samples
What intervention reduced crying time and neonatal infant pain scores during heel lance procedure?
Swaddling
Which combination was found to be most effective for analgesia during deep heel stick procedures?
Non-nutritive sucking, swaddling, and oral sucrose
What was the impact of smaller flush volume of arterial blood on sample results?
May impact sample results by dilution
What did repeated painful stimuli in early life increase the likelihood of?
Displaying pain response during routine heel prick
What software was used for removing duplicate citations during the literature search?
EndNote X7
How many peer-reviewed articles were retrieved by the search strategies?
3,636
What method did the committee use to review evidence and derive recommendations for each PICO question?
Standardized multi-round rating process
How were study selection eligibility assessed in the Covidence systematic review software?
By at least two independent reviewers
What was the purpose of the flow chart used by the committee?
To demonstrate the literature search process
Which blood gas values did McLain et al. find to satisfactorily represent arterial values?
Arterial and capillary pH and PCO2
Which study found statistically significant differences for all blood gas values when comparing arterialized capillary blood with arterial blood specimens in preterm neonates?
Saili et al.
Which type of blood gas samples did Yang et al. note to have significantly higher PaO2 and arterial oxygen saturation in infants?
Arterial samples compared with capillary samples
What did the systematic review provide a summary of evidence for?
All of the above
What must be established before clinical use according to the text?
The reliability of venous and capillary blood gas values as surrogates for arterial blood gas values
Study Notes
Comparison of Arterial, Venous, and Capillary Blood Gas Values in Pediatrics
- Out of 2,502 articles, 92 articles underwent full-text review and 26 studies met the inclusion criteria.
- The reliability of venous and capillary blood gas values as surrogates for arterial blood gas values must be established before clinical use.
- Limited studies address the reliability of alternative blood gas sampling methods in pediatrics across different age groups.
- No studies were found that compared arterial versus venous blood gas results in preterm infants admitted to a neonatal ICU.
- Studies evaluated differences in arterial and arterialized capillary blood gas values in neonates and children.
- McLain et al. reported that arterial and arterialized capillary pH and PCO2 satisfactorily represented arterial values.
- Saili et al. found statistically significant differences for all blood gas values when comparing arterialized capillary blood with arterial blood specimens in preterm neonates.
- Yang et al. noted significantly higher PaO2 and arterial oxygen saturation in arterial samples compared with heel puncture samples in infants.
- Four clinical studies evaluated differences in arterial and capillary blood gas values, some including a comparison with samples from a peripheral vein.
- The impact of pre-analytic errors on blood gas and pH errors, collection technique on patient complications, and handling of blood obtained from capillary sites were addressed in the studies.
- Various studies compared capillary blood gas samples with arterial or venous samples, warmed and unwarmed heel capillary samples, and sample delivery methods.
- The systematic review provided a summary of evidence for each PICO question addressed in the study.
Pediatric Blood Gas Values Comparison Quiz: Test your knowledge on the reliability of arterial, venous, and capillary blood gas values in pediatrics. Explore the differences in blood gas values across different age groups and sampling methods, and understand the impact of pre-analytic errors on patient care.
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