Shabih Manzar.
Appropriateness of Blood Gas Analysis in newborns with respiratory distress.
Pak J Med Sci Jan ;20(1):33-5.

Objective: To look at the appropriateness of blood gas analysis in newborn with respiratory distress. Subjects & Methods: We carried out an audit at the neonatal intensive care unit (NICU) of King Fahd Hospital of the University, Al-Khobar, Saudi Arabia. All newborn who got admitted to the NICU with the signs of respiratory distress were included. The neonates were only receiving oxygen as respiratory support. None were intubated or received positive pressure ventilation. The records of sixteen newborns with admission blood gas analysis available were reviewed. Results: Except for the two cases, none had hypoxemia (PaO2 < 80 mm Hg). Similarly only two cases were noted to have acidosis (pH < 7.30) while only one case had hypercarbia (PaCO2 > 40 mm Hg). The base excess and bicarbonate measurements, in most of the cases, were also within the normal range. Conclusions: The blood gas analyses were essentially normal of most of the samples suggesting inappropriateness and unnecessary use of this painful and costly procedure in otherwise stable newborns with respiratory distress. Based on these findings, an alternative approach, a combination of clinical parameters, pulse oximeter reading and findings on chest x-ray is suggested that may be useful in management of neonates with respiratory distress. The goal is to minimize the overuse of invasive painful procedure.

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