PT - JOURNAL ARTICLE AU - Kelly, Anne-Maree TI - Can VBG analysis replace ABG analysis in emergency care? AID - 10.1136/emermed-2014-204326 DP - 2016 Feb 01 TA - Emergency Medicine Journal PG - 152--154 VI - 33 IP - 2 4099 - http://emj.bmj.com/content/33/2/152.short 4100 - http://emj.bmj.com/content/33/2/152.full SO - Emerg Med J2016 Feb 01; 33 AB - Blood gas analysis is an integral part of the assessment of emergency department (ED) patients with acute respiratory or metabolic disease. Traditionally ABG analyses have been used, but increasingly, emergency clinicians are using venous blood gas (VBG) analyses. This has been challenged, especially by respiratory physicians, as being too inaccurate. This clinical review, using case examples, summarises the evidence supporting use of VBG to guide management decisions. Arteriovenous agreement for pH is such that values are clinically interchangeable and agreement for bicarbonate is also close. Agreement for pCO2 is poor with 95% limits of agreement of the order of 20 mm Hg (2.67 kPa); however, there is solid evidence that a venous pCO2 ≤45 mm Hg (6 kPa) reliably excludes clinically significant hypercarbia. Evidence regarding arteriovenous agreement for base excess is unclear. Given knowledge of the performance characteristics of VBG analyses, integration of the clinical findings with VBG results is often sufficient to safely guide treatment decision making.