Arterial Blood Gas Sampling and Pitfalls

Arterial blood sampling remains an extremely important procedure for the critical care physician. In 1711, Stephan Hales performed the first blood vessel cannulation by inserting brass pipes in the arterial and venous vasculature of a horse. Since then, the practice of arterial blood sampling and cannulation has evolved and remains a vital procedure, performed daily in the critically ill population. Measurements of arterial pH and partial pressures of oxygen and carbon dioxide provide precise information regarding a patient s acid–base balance and gas exchange. Although a majority of the critically ill patients have an arterial catheter in situ, all medical trainees and intensivists need to be proficient with the procedure, interpretation, and pitfalls of arterial blood puncture. In this chapter, we discuss the anatomy of the vasculature; indications, the procedure, common complications; and pitfalls associated with the interpretation of arterial blood gas sampling.