Frequency of blood gas monitoring

[doc4tots]

Hello, all.

Curious to know if there are guidelines that you follow for frequency of monitoring blood gases in acutely ill infants? Every 1, 2, 4 hours? With every ventilator change? Based on 'clinical assessment?'

What about chronically ventilated infants with BPD? Recovering infants on nasal CPAP or nasal cannula?

Happy holidays!

[Stefan Johansson]

In our units we don't have any strict guidelines regarding the frequency blood gases sampling. Every day we write an individual Ventilation Plan for each patient, which includes the approximate number of blood gase over the coming 24 hours.

Given arterial access we take rather frequent b-gases in the most dynamic (early) stage of lung disease. For example, in a ELBW infant with RDS we typically sample every 2-6 hours over the first 1-3 days. Usually, when we change ventilatory supprot (from MV to HFV, or vice versa, or postextub to CPAP) we check a blood gas after one hour.

When our infants grow older (and there's no arterial access) we check blood gases much less frequent, we try to monitor transcutaneously as much as possible. For example, in a chronic stable BPD-patient we may sample blood gases once or twice a week.