The effects of bedside blood gas monitoring on blood loss and ventilator management.

INTRODUCTION: We examined whether the bedside SensiCath Blood Gas Monitoring System could reduce both blood loss and the time needed to make ventilator-setting changes in a population of very low birth weight (VLBW; <1,500 g) infants. MATERIAL AND METHODS: A prospective, group sample trial was conducted on ventilator-dependent newly born VLBW infants. The trial was unblinded due to the nature of the device and parental consent was obtained before study enrollment. A total of 44 patients were studied. RESULTS: There was no difference (mean +/- SD) between the SensiCath group and controls with respect to birth weight, gestational age, pH, PCO(2), PO(2) or Apgar at 5 min (median 6, both groups). The amount of blood loss for arterial blood gas (ABG) measurement alone was less in the SensiCath group compared to the control group (1.2 +/- 0 ml vs. 6.7 +/- 2.4 ml, p < 0.001) and the total blood loss was also less in the SensiCath group (8.1 +/- 5 ml vs. 10.5 +/- 6.3 ml, p < 0.001), but there was no significant difference between each group in the amount of blood transfused. The time to obtain ABG results and to make a ventilator change was shorter in the SensiCath group compared to control (2 +/- 0 vs. 26 +/- 21 min, p < 0.001). DISCUSSION: Use of the modified SensiCath monitoring system permits near zero blood loss for ABG assessment and greatly reduces the time needed to make ventilator management decisions.

Duke Scholars

Author David Timothy H. Tanaka Pediatrics, Neonatology