Clinical application analysis of point-of-care arterial blood gas analysis in the intensive care unit
床旁动脉血气分析在重症医学科的临床应用分析

摘要

目的 评价床旁动脉血气分析在重症医学科（ICU）患者中的应用价值，并与常规送检模式比较其检测结果与流程效率。方法 连续纳入24年1月到25年1月本院 ICU 需行血气监测的患者 68例，随机数表法分为实验组（床旁血气分析，n＝34）和对照组（常规送检，n＝34）。两组性别、年龄、APACHE Ⅱ 评分及机械通气比例等基线指标差异均无统计学意义（P＞0.05）。实验组采血后置入 GEM Premier 3500 全自动血气分析仪，于床旁 3-5 min 获得结果；对照组标本私用ABL800Flex血气分析仪测定分析。比较两组酸碱平衡（pH、AB/SB、BB）、氧合（PaO₂）、电解质（K⁺、Ca²⁺）及分析用时。结果 两组 pH、AB/SB、BB及 PaO₂差异均无统计学意义（P＞0.05）。实验组 K⁺ 和 Ca²⁺ 低于对照组。实验组分析用时显著短于对照组。结论 床旁动脉血气分析在酸碱与氧合指标上与传统送检方法一致，且能更及时、准确地反映电解质状态，并显著缩短报告时间；适合 ICU 快速诊疗流程，值得临床推广。

Abstract

Objective To evaluate the application value of bedside arterial blood gas analysis in patients in the Intensive Care Unit (ICU) and compare its test results and process efficiency with those of the conventional specimen-sending model.
Methods A total of 68 patients requiring blood gas monitoring in the ICU of our hospital from January 2024 to January 2025 were continuously enrolled and randomly divided into an experimental group (bedside blood gas analysis, n = 34) and a control group (conventional specimen-sending, n = 34) using the random number table method. There were no statistically significant differences in baseline indicators such as gender, age, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, and the proportion of patients on mechanical ventilation between the two groups (P > 0.05). In the experimental group, blood samples were placed into the GEM Premier 3500 fully automated blood gas analyzer after collection, and results were obtained within 3–5 minutes at the bedside. In the control group, specimens were analyzed using the ABL800Flex blood gas analyzer. Acid-base balance (pH, AB/SB, BB), oxygenation (PaO₂), electrolytes (K⁺, Ca²⁺), and analysis time were compared between the two groups.
Results There were no statistically significant differences in pH, AB/SB, BB, and PaO₂ between the two groups (P > 0.05). The levels of K⁺ and Ca²⁺ in the experimental group were lower than those in the control group. The analysis time in the experimental group was significantly shorter than that in the control group.
Conclusion   Bedside arterial blood gas analysis yields consistent results with traditional specimen-sending methods in terms of acid-base and oxygenation indicators. It can more promptly and accurately reflect electrolyte status and significantly shorten the reporting time. It is suitable for the rapid diagnosis and treatment process in the ICU and is worthy of clinical promotion.