2013 AARC血气分析和血氧测量指南.pdf

AARC Clinical Practice Guideline: Blood Gas Analysis and Hemoximetry: 2013 Michael D Davis RRT, Brian K Walsh RRT-NPS RPFT FAARC, Steve E Sittig RRT-NPS FAARC, and Ruben D Restrepo MD RRT FAARC We searched MEDLINE, CINAHL, and Cochrane Library database for articles published between January 1990 and December 2012. The update of this clinical practice guideline is based on 237 clinical trials, 54 reviews, and 23 meta-analyses on blood gas analysis (BGA) and hemoximetry. The following recommendations are made following the Grading of Recommendations Assessment, Development, and Evaluation scoring system. BGA and hemoximetry are recommended for eval- uating a patient’s ventilatory, acid-base, and/or oxygenation status. BGA and hemoximetry are suggested for evaluating a patient’s response to therapeutic interventions. BGA and hemoximetry are recommended for monitoring severity and progression of documented cardiopulmonary disease processes. Hemoximetry is recommended to determine the impact of dyshemoglobins on oxygen- ation. Capillary BGA is not recommended to determine oxygenation status. Central venous BGA and hemoximetry are suggested to determine oxygen consumption in the setting of early goal- directed therapies. For the assessment of oxygenation, a peripheral venous PO is not recommended 2 as a substitute for an arterial blood measurement (PaO ). It is not recommended to use venous PCO 2 2 and pH as a sub