• Satoshi Kurisu, Noriaki Watanabe, Hiroki Ikenaga, Tadanao Higaki, Takashi Shimonaga, Toshitaka Iwasaki, Ken Ishibashi, Yoshihiro Dohi, Yukihiro Fukuda, and Yasuki Kihara.
• Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan.
• Intern. Med. 2015 Jan 1; 54 (15): 1841-7.

ObjectiveAnalyses of arterial blood gas parameters, including pH, HCO3- and lactate, play an important role in assessing the clinical status of patients with heart failure. In the present study, we evaluated the degree of agreement in the pH, HCO3- and lactate levels between arterial and venous blood samples according to the subset of the Forrester classification.MethodsThe study population consisted of 128 patients with known or suspected heart failure. The subjects were divided into four groups based on the Forrester classification. Arterial blood samples were drawn from the radial or brachial artery, and venous blood samples were drawn from the pulmonary artery.ResultsThere were 59 patients with a Forrester subset I status, 32 patients with a subset II status, 21 patients with a subset III status and 16 patients with a subset IV status. The pH and HCO3- levels were similar between the four subsets. In all subsets, the pH values were significantly higher and the HCO3- values were significantly lower in the arterial blood samples than in the venous blood samples. There was good correlation and agreement in the pH and HCO3- levels between the arterial and venous blood samples. In contrast, there was a significant difference in the lactate levels in both the arterial and venous blood samples between the four subsets, and the lactate levels were highest in subset IV. In all subsets, there was good correlation and agreement in the lactate levels between the arterial and venous blood samples.ConclusionThese data suggest that the venous pH, HCO3- and lactate levels are acceptable substitutes for arterial parameters, regardless of the cardiac hemodynamics.

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