Arterial blood gas testing is one of the most ordered tests in the ICU environment and is often done routinely rather thanrestricting it to assess a change in oxygenation, ventilation or acid-base that cannot be assessed through other means. The evidence indicates that 33-66% of ABG tests may not be clinically warranted and that redundant testing can besafely reduced.
Chest radiographs are indicated following procedures requiring verification after insertion (e.g., endotracheal intubation),or to provide information for a specific question related to a change in patient’s clinical condition. Blood tests should only be performed to monitor specific conditions or answer specific clinical questions.
Sources:
Chandran J, D’Silva C, Sriram S, Krishna B. Clinical utility of arterial blood gas test in an intensive care unit: An observational study. Indian J Crit Care Med. 2021 Feb;25(2):172-175. PMID: 33707895.
Choosing Wisely Canada. Canadian Critical Care Society, Canadian Association of Critical Care Nurses, Canadian Society of Respiratory Therapists: Twelve Tests and Treatments to Question . [Internet]. 2022 Jul. Updated August 2024 [cited 2024 Jan 11].
Martínez-Balzano CD, Oliveira P, O’Rourke M, Hills L, Sosa AF; Critical Care Operations Committee of the UMass Memorial Healthcare Center. An educational intervention optimizes the use of arterial blood gas determinations across ICUs from different specialties: A quality-improvement study. Chest. 2017 Mar;151(3):579-585. Epub 2016 Nov 3. PMID: 27818327.
Walsh OM, Davis K, Gatward J. Reducing inappropriate arterial blood gas testing in a level III intensive care unit: a before-and-after observational study. Crit Care Resusc. 2023 Oct 18;22(4):370-377. PMID: 38046871.