Diagnostic Accuracy of VBG in DKA

Diabetes PGY1 PGY2 PGY3 PGY4

We all know that VBG can be replaced with ABG for a lot of reasons, but our consulatants are still asking for ABG in DKA, COPD, Asthma and etc. I will post some data that show VBG is as good as ABG unless you have a patient under vent. 
Diagnostic Accuracy of Venous Blood Gas Electrolytes for Identifying Diabetic Ketoacidosis in the Emergency Department.

This study published in Academic Emergency Medicine Journal 2011 and authors used ADA’s criterias for DKA diagnosis (serum blood glucose 250 mg⁄ dL, serum anion gap > 10 mEq⁄ L, bicarbonate <= 18 mEq⁄ L, serum pH< = 7.30).  VBG electrolytes for diagnosing DKA was 97.8% sensitive (95 confidence interval [CI] = 88.5% to 99.9%) and 100% specific(95% CI = 98.8% to 100%). One DKA patient out of fourty six patients was missed based on VBG.

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