Obtaining arterial blood gas reference values in an adult population residing at high altitude using CLSIEP28 - A3C standards
DOI:
https://doi.org/10.5281/zenodo.8051006Keywords:
Blood Gas Analysis, Reference Standards, Reference values, Altitude, Physiological Adaptation, Ecuador.Abstract
Introduction: arterial blood gas values are related to geographical location due to oxygen availability and physiological adaptation capacity.
Objective: to determine arterial blood gas reference values in a clinically healthy population at 2800 meters above sea level.
Method: observational, analytical and cross-sectional study in healthy subjects residing in Quito, attending the Eugenio Espejo hospital, selecting a sample of 264 patients by simple random sampling. The Guide for calculating reference values suggested by the Clinical Laboratory Standards Institute was applied. The data were stored and analyzed in SPSS v18.0. For the calculation of the reference values, the 2,5 and 97,5 percentile were considered as limits of the intervals.
Results: mean age was 29,9±5,4 for men and 26,8±6,1 for women (p<0,05). Arterial blood gases showed as results: (pH: men 7,417 (7,387-7,452), women 7.422 (7,391-7,456); PCO2: men 32,5 mmHg (27,3-36,1), women 31,5 mmHg (26,5-35,7); PO2: men 69,6 mmHg (59,6-83,2); HCO3: men 20,4 mEq/L (17,8-22,4), women 20,2 mEq/L (18,0 -21,9)) presented statistically significant differences compared to values at sea level.
Conclusions: the values obtained in arterial blood gases in healthy population at sea level compared to those obtained in the city of Quito at 2800 meters above sea level were significantly variable, with PO2 and O2 levels lower than those established at sea level for men and PCO2 and pH for both sexes.
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2. Pereira-Victorio C, Huamanquispe-Quintana J, Castelo-Tamayo, LE. Gasometría arterial en adultos clínicamente sanos a 3350 metros de altitud. Rev Peru Med Exp Salud Pública [Internet]. 2014 [citado 11/12/2022]; 31(3):473–9. Disponible en: http://www.scielo.org.pe/scielo.php?script=sci_arttext&pid=S1726-46342015000100037
3. Horowitz GL. EP28 A3C - Defining, Establishing, and Verifying Reference Intervals in the Clinical Laboratory. 3rd ed. Clinical and Laboratory Standards Institute, editor. 2010.
4. Beall CM, Brittenham GM, Strohl KP, Blangero J, Williams-Blangero S, Goldstein MC, et al. Hemoglobin concentration of high-altitude Tibetans and Bolivian Aymara. Am J Phys Anthropol. 1998;106(3):385–400.
5. Sáenz FK, Narváez GL, Cruz M. Valores de referencia hematológicos en población altoandina ecuatoriana establecidos con el uso del analizador Sysmex XE-2100. Rev Mex Patol Clin Med Lab. 2008;55(4):207–2015.
6. Hinojosa-Campero WE. Gasometría arterial y adaptación en la altura. Rev Médico-Científica “Luz y Vida.” 2011 Jun;2(1):39–45.
7. Calderón Gerstein W, López Martínez O. Valores gasométricos en población adulta y adulta mayor residente de gran altitud. An la Fac Med [Internet]. 2020 [citado 11/12/2022]; 81(2):18032. Disponible en: https://revistasinvestigacion.unmsm.edu.pe/index.php/anales/article/view/18032
8. Gassmann M, Mairbäurl H, Livshits L, Seide S, Hackbusch M, Malczyk M, et al. The increase in hemoglobin concentration with altitude varies among human populations. Ann N Y Acad Sci [Internet]. 2019 [citado 11/12/2022]; 2019:nyas.14136. Disponible en: https://onlinelibrary.wiley.com/doi/10.1111/nyas.14136
9. Mejia CR, Cáceres OJ, Rodriguez-Alarcon JF, Corrales-Reyes IE. Variaciones fisiológicas y antropométricas en trabajadores según su residencia en tres altitudes geográficas del Perú. Rev Cuba Investig Biomédicas [Internet]. 2020 [citado 11/12/2022] 39(3):e611. Disponible en: https://revibiomedica.sld.cu/index.php/ibi/article/view/611/873
10. Ricardo A, Emma M, Daniela P, Julieta L, Silvia M, Carlos J, et al. Eritrocitosis Patológicas Con Niveles De Eritropoyetina Baja E Incrementada : Características Clínicas Y Laboratoriales. Rev Médica La Paz [Internet]. 2022 [citado 11/12/2022]; 28(1):27–32. Disponible en: http://www.scielo.org.bo/scielo.php?script=sci_arttext&pid=S1726-89582022000100027&nrm=iso
11. Sanabria Pérez ES, Ercilla Sánchez JG, Aguirre-Zurita O. Impacto de la variación de la altura sobre el nivel del mar en los parámetros clínicos y hemodinámicos en hipertensión arterial pulmonar: a propósito de un caso. Arch Peru Cardiol y Cirugía Cardiovasc [Internet]. 2021 [citado 11/12/2022]; 2(1):68–71. Disponible en: https://apcyccv.org.pe/index.php/apccc/article/view/93
12. Palencia-Mojica CL, Valero-Ortiz AS, Silva-Rodríguez LJ. Comportamiento clínico y gasométrico en falla respiratoria aguda tratada con cánula nasal de alto flujo. Univ y Salud [Internet]. 2020 [citado 11/12/2022]; 22(2):102–11. Disponible en: https://revistas.udenar.edu.co/index.php/usalud/article/view/4503
13. Paredes Gonzalez KF, Zabala – Haro A. Características Morfofuncionales del Hombre de Altura. Cienc Lat Rev Científica Multidiscip [Internet]. 2023 [citado 11/12/2022]; 7(1):14251–73. Disponible en: https://ciencialatina.org/index.php/cienciala/article/view/5846
14. Vaca García MR, Rosas Mora ME, Alarcón Calero FL, Paredes Navarrete LR, Fernández Concepción RR, Alomoto Mera M de los Á. Intercambio de gases respiratorios, respuestas cardiacas y metabólicas en altitud: estudio en pentatletas ecuatorianos. Rev Cuba Investig Biomédicas [Internet]. 2019 [citado 11/12/2022]; 38(2):e298. Disponible en: https://revibiomedica.sld.cu/index.php/ibi/article/view/298/277
15. Maldonado D, Gonzalez-Garcia M, Barrero M, Casas A, Torres-Duque CA. Reference Values For Arterial Blood Gases At An Altitude Of 2640 Meters. In: C76 EXERCISE, HYPOXIA, AND ALTITUDE. American Thoracic Society; 2013. p. A4852–A4852.