الفهرس 
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Abstract
An arterial-blood gas (ABG) test measures the blood-gas tension values of the arterial partial pressure of oxygen, and the arterial partial pressure of carbon dioxide, and the blood’s pH. In addition, the arterial oxygen saturation can be determined. Such information is vital when caring for patients with critical illnesses or respiratory disease. Therefore, the ABG test is one of the most common tests performed on patients in intensive-care units (Sood et al., 2010).
Arterial blood gas analysis is an essential part of diagnosing and managing a patient’s oxygenation status and acid-base balance. Improper sampling may result in fallacious results and inappropriate management. Additionally, poor sampling technique may increase the rate of complications. Arterial puncture is also painful, particularly when more than one attempt is required (Giner et al., 1996).
Ultrasound technology has become more compact and consequently more prevalent in emergency department and intensive care units. Ultrasound can obviously aid in diagnosis, but increasingly it is also being used to guide invasive procedures such as vascular access (Sandhu and Sidhu, 2004).
The aim of this study is to evaluate the use of ultrasound in ABG sampling in patients admitted to respiratory ICUs in Ain-Shams university hospitals.
The present study was conducted on (150) subjects admitted to respiratory ICUs in Ain-Shams university hospitals and recommended for arterial blood sample for arterial blood gas analysis.
All Patients were subjected to:
Complete history taking - from the patient &/or his relatives and through clinical examination.
Vital data.
The admitting diagnosis has been made by the attending physician.
Complete blood picture and bleeding profile (PT – PTT – INR).
Arterial blood gas sampling.
The following results were obtained:-
- from all patients 76 patients had respiratory failure type II, while 74 patients had respiratory failure type I.
- 26 patients were shocked.
- All patients were on either prophylactic or therapeutic anticoagulation. Twelve cases [8%] had INR>1.5 and 32 cases [22.6%] had platelets count < 150,000.
- from all cases 79 case were difficult.
- 66 cases were difficult due to edema [83% of difficult cases].
- 26 cases were difficult due to imperceptible pulse (shock), [32.9% of difficult cases].
- 10 cases were difficult due to obesity (weak pulse), [12.6% of difficult cases].
- 21 cases were difficult due to combined edema imperceptible pulse [26.5% of difficult cases].
- Ultrasonography-guided puncture was performed using long-axis technique in 134 (89.3%) of cases and short-axis technique in 16 (11.7%) of cases.
- First attempt was unsuccessful in 3 cases [2%]; all were done with long-axis technique.
- Double puncture occurred in 3 cases [2%] done with long-axis technique.
- Post-puncture hematoma attributed to poor compression after the puncture occurred in one case [0.6 %] with a long- axis technique.
from this study, it was concluded that:-
Ultrasound is an effective and safe method in guidance for arterial puncture for arterial blood gas analysis with increase first attempt success rate and few complications