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VBG vs ABG

Notes: In a meta-analysis, Bloom et al. note that there is good correlation between arterial and venous pH and HCO3. They also concluded that despite variability in arterial and venous pCO2 and lactate, normal venous levels have good negative predictive values. 1 Zeserson et al. studied VBG and SaO2 (pulse oximetery) results in critically ill patients. This population included 41% ED,

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DKA and HHS

Definitions: Diabetic ketoacidosis (DKA)1,2– uncontrolled hyperglycemia, metabolic acidosis, and increased total body ketones Hyperosmolar hyperglycemic state (HHS)1,2– severe hyperglycemia, hyperosmolality, and dehydration in the absence of significant ketoacidosis Treatment: Fluid resuscitation:1,2 NS (0.9%NaCl) 15-20 ml/kg or 1-1.5 liters in first hour … THEN If corrected serum Na is low, cont. NS @ 250-500 ml/hr If corrected serum Na is high

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