If the pCO2 is too high, as reflected in the second image, then it cannot calculate the bicarb and you're left with a blank value. No major flaws were found in the analysis, but it was deemed to beirrelevant (one reviewer wrote This meta-analysis describes well a way to calculate ABG from VBG. Estimating the ABG value as equal to the VBG value (as is often done in clinical practice). Whether or not this analysis holds true for central venous specimens is unknown. He is a co-founder of theAustralia and New Zealand Clinician Educator Network(ANZCEN) and is the Lead for theANZCEN Clinician Educator Incubatorprogramme. The accuracy of three methods for interpreting VBG values were tested using this data: Below are the results. Kidney360. PMID. For every 1 unit increase in AG (AG) from its upper limit of normal value (12), there is an expected 1 drop in HCO3 (HCO3) from its normal value (24). Kelly AM. He withdrew permission to use his data. Yet, even a slight decrease in their function can lead to significant illness, such as acidosis or alkalosis. Serum CK if there is suspicion for massive rhabdomyolysis. Part compensation occurs when the PCO 2 and HCO 3 rise or fall together but the pH remains abnormal. This again emphasizes that small differences in ABG values aren't clinically relevant. Here they are and their normal numeric values (commit them to memory): pH: 7.35-7.45 CO2: 35-45 (CO2 lab value ALWAYS indicates a RESPIRATORY issue) There is a significant difference in the readings presented. and transmitted securely. 2001, 2023 The Regents of the University of California, VBG can provide reliable estimation for pH (0.02-0.04. The concentration of 2,3-DPG is within a very limited range C. The temperature of the patients is very close to 37C D. The hemoglobin-iron concentration is within a very narrow range. All you need to know is a few parameters: The acid-base calculator estimates the level of oxygenation from the first three values. The bicarbonate ion leaves the RBC and enters the plasma, allowing the chloride ion to enter the RBC. If the AG not elevated, there is not an anion gap metabolic acidosis present. BE is the Base excess (SBE for Standar Base Excess). As an example, if a patient has a PaO 2 of 100 mmHg while receiving 80 percent oxygen, then the PaO 2 /FiO 2 ratio is 125 mmHg (ie, 100 mmHg/0.8). display: inline; (Kelly 2001, Razi 2012, Brandenburg 1998, McCanny 2012, Byrne 2014). The total body water calculator estimates the total volume of water in your body. The venous oxygen saturation varies quite a bit, between roughly 10%-95%. Nevertheless, the value of using central VBG to guide clinical decisions or as a surrogate for ABG is unclear. Clinical Physiology of Acid-Base and Electrolyte Disorders: 5th Edition. This can be done with the use of a third assumption. Physiological Approach to Assessment of AcidBase Disturbances. For severe hypoalbuminemia (2.0 g/dl), the expected gap would be 5 +/- 2, and an AG of 8-12 would be abnormally elevated. The difference in oxygen saturation is the difference between the venous and arterial oxygen saturation (shown below). Preference cookies are used to store user preferences to provide content that is customized and convenient for the users, like the language of the website or the location of the visitor. However, arterial puncture may result in complications, and the difficulty in acquiring arterial blood may delay care. Even I noted that too many patient get ABGs taken for no obvious clinical reason. The above data pertains to VBGs drawn from the arm. Proceed to step 3. For medical use, it calculates the pH of the blood by inserting the HCO (in mEq/L or mmol/L) and PaCO (in mmHg or torr) values in the following formula: pH = 6.1 + log10[HCO / (0.0308 PaCO)], Wondering how many helium balloons it would take to lift you up in the air? Acid-base homeostasis is a highly complex process in the body. Lumholdt M, Damgaard KA, Christensen EF, Leutscher PDC. I was kindly provided with one dataset from Dr. Geraldine McMahon from her publication (McCanny 2012). beats/min. Since performing this analysis, a few studies have come out suggesting that VBG values are closer to ABG values than was generally believed (e.g. http://blog.clinicalmonster.com/2017/01/update-consider-mathematical-arterialization-vbgs-ed-patients/, Great post, thanks for sharing it. official version of the modified score here. Minimize the duration oftourniquet application (e.g., if the patient has a venous catheter that allows blood to be withdrawn, slowly pull blood off the venous catheter. Find the effective radiation dose from standard medical procedures with our medical radiation calculator. Your content should go viral. See specific acid-base disturbances for other helpful testing. The bicarbonate buffering system is the method by which the body controls pH and is crucial to understand arterial and venous blood gas results. These cookies track visitors across websites and collect information to provide customized ads. article published in Journal of Clinical & Diagnostic Research, Check out 20 similar electrolytes & fluids calculators . Arterial blood gases (ABG's) - blood sample taken directly from an artery used to gauge the metabolic environment, oxygenation, and ventilation status. Dr No has acted unethically here. Thus, the data set suggesting the lowest error is closest to the true error involved in extrapolation from VBG to ABG data (2). 2010;22:493498. A doctor begins by taking a blood sample from an artery, most commonly the radial artery, or sometimes the femoral and brachial arteries. Among the most important information we can gain from blood gas values is the pH of the blood. The final equations derived to convert from VBG to ABG values are as follows: Here is where things fall apart without Dr. No's data. SaO2 %95 - 97. Automatic software that works with existing BGAs and already in clinical use with several hospitals in Europe. Sodium and chloride are required for anion gap calculation. What we need is something freely available to the scientific community in a form which can be easily replicated, investigated, and utilized (e.g. Chu YC, Chen CZ, Lee CH, Chen CW, Chang HY, Hsiue TR. A blood gas analysis or also arterial blood gas (ABG) test is the most popular name for the test. It is important to follow a systematic approach each time interpreting a blood gas. ABG values are generally taken as the gold-standard for pH assessment. (arm, leg, femoral vein, SVC). What is the pathophysiology of saline-induced normal anion gap (hyperchloremic) metabolic acidosis? Based on a work athttps://litfl.com. Note: UAG should not be used if there is excretion of another anion (lactate, DKA anions, etc.) Blood gas analyzers typically warm blood to 37C before making calculations however physicians should simply interpret the values as given by the lab. Before Venous blood gases (VBG) are widely used in the emergency setting in preference to arterial blood gases (ABG) as a result of research published since 2001 The weight of data suggests that venous pH has sufficient agreement with arterial pH for it to be an acceptable alternative in clinical practice for most patients We concluded that central VBG parameters of pH and Pco2 are potentially good surrogates for determining arterial pH and Pco2 in a stable patient without severe acid-base disturbances. Central venous blood gas (VBG) is a potentially more accessible alternative to ABG sampling. It is used to help us to recognize when a patient's body is extracting more oxygen than normally. He created the Critically Ill Airway course and teaches on numerous courses around the world. The venous blood gas calculator estimates the venous blood pH using bicarbonate (HCO) values and arterial carbon dioxide partial pressure (PaCO) in the patient's blood. SIG is the Strong Ion Gap. Evaluate for physiologic compensation for the acid-base disorder. PMID: Kelly AM, McAlpine R, Kyle E. Venous pH can safely replace arterial pH in the initial evaluation of patients in the emergency department. This site represents our opinions only. We examined the agreement between ABG and VBG parameters and between ABG and pulse oximetry measurements of oxygen saturation in COPD exacerbations and found acceptable agreement for pH, and for SaO 2 at an SpO 2 >80%. The results displayed in the right side column are those obatined from formulas that take into account the Hb level (not used in the left column). The VBG is of no value in assessing oxygenation status. All cited references from included studies were also reviewed to identify relevant literature. Let's start by analyzing these datasets using the direct correlational model (below), which is the conventional way of looking at these datasets. Hi,I check your new stuff named Venous blood gas (VBG) interpretation Oxford Medical Education on a regular basis.Your writing style is witty, keep up the good work! ABG's vs VBG's in the Emergency Department. 3. Here are other differences. The relationship between pH and CO2 is complex, based partially on the Henderson-Hasselbach equation. HCO3 calculation is also provided (some blood gaz machines do not provide this result). 70 years. The relatively low incidence of major complications, [ 1] its ability to be performed at the patient's bedside, and its rapid analysis make it an important tool used by physicians to direct and redirect the treatment of their . I must say you have hi quality articles here. . Subsequent to failed publication attempts as described above, I requested data from investigators who had more recently published papers. Knowing your BMR (basal metabolic weight) may help you make important decisions about your diet and lifestyle. It means that venous blood is more acidic than arterial. A mixed acid-based disorder consists of any combination of at least two disorders: two metabolic disturbances OR one respiratory and one metabolic. In light of the above if there is no concern about the respiratory system it is reasonable to take a VBG as opposed to an ABG in the first instance when presented with an unwell patient. Emerg Med J. Actual bicarbonate is the concentration of hydrogen carbonate in the plasma. SID means Strong Ion Difference (SIDa and SIDe for SID apparent or effective). How to calculate the anion gap? To be used for the evaluation of the quality of the compensatory response of the patient. In most cases of normal anion gap metabolic acidosis, it is probably safe. Imagine blood flowing from the radial artery to a vein in the hand. Necessary cookies are absolutely essential for the website to function properly. This calculator only differentiates between acute (pH abnormal) and compensated (pH normal). Disclaimer. New England Journal of Medicine. Years passed. OSF or Zenodo). The aim was to . Albumin. However, arterial puncture may result in complications, and the difficulty in acquiring arterial blood may delay care. 6-step approach: Step 1: Assess the internal consistency of the values using the Henderseon-Hasselbach equation: [H+] = 24 (PaCO2) [HCO 3 -] If the pH and the [H+] are inconsistent, the ABG is probably not valid. Venous Blood Gas (VBG) samples can be used for Acid-Base analysis - Arterial Blood Gas (ABG) samples are required only for PO 2 and for PaO 2 - VBG samples are acceptable because pH and PCO 2 are comparable to ABG samples exception: patients in severe circulatory failure (shock) VBG samples can also be used to measure We report our findings from a retrospective audit in medical in-patients and the potential benefit of this underused resource. The https:// ensures that you are connecting to the This post is about a research project I did as a pulmonary critical care fellow in 2011. Centralvenous oxygen saturation (ScvO2) monitoring, Venous and Arterial Blood Gas Analysis in the ED, Can a Venous Blood Gas Substitue for an Arterial Blood Gas, Clinical Adjunct Associate Professor at Monash University, Australia and New Zealand Clinician Educator Network, Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License, Venous blood gases (VBG) are widely used in the emergency setting in preference to arterial blood gases (ABG) as a result of research published since 2001, The weight of data suggests that venous pH has sufficient agreement with arterial pH for it to be an acceptable alternative in clinical practice for most patients, Nevertheless acceptance of this strategy has been limited by some specialties and maybe inappropriate in some settings; for instancethere is no data to confirm that this level of agreement is maintained in shock states or mixed acid-base disturbances, Clinically acceptable limits of agreement for blood gas parameters remains poorly defined, gold standard test for determining the arterial metabolic milieu (pH, PaCO2, HCO3), pH, PCO2 (if normocapnic), HCO3 and base excess from a VBG are usually adequate for clinical decision making, SpO2 is usually sufficient for clinical decision making unless pulse oximetry is unreliable for other reasons (e.g. Therefore, if the lungs stop working, one should present with metabolic compensation. The process of blood gas and pH measurement involves preheating the arterial blood sample to normal body temperature (37 C) prior to measurement of pH, partial pressure of oxygen (pO 2) and partial pressure of carbon dioxide (pCO 2).This ensures that results reflect in vivo temperature condition. A 2021 narrative review of the literature suggested the following ABG conversion from central VBG: A. Arterial pH = venous pH + 0.05 units; and B. Arterial Pco2 = venous Pco2 - 5 mm Hg (1). Performance cookies are used to understand and analyze the key performance indexes of the website which helps in delivering a better user experience for the visitors. Remember that chronic acid-base disturbance(s) and/or mixed acute acid-base disturbances can be obscured by a normal pH. CO2 + H2O + CA => H2CO3. An arterial blood gas (ABG) is the traditional method of estimating the systemic carbon dioxide tension and pH, usually for the purpose of assessing ventilation and/or acid-base status. programmed into MDCalc). Miscellaneous: poorly resorbed anion (high dose carbenicillin or other penicillin derivatives), refeeding alkalosis, administration of alkali (excessive treatment for acidosis, massive transfusions with citrate anticoagulant, milk alkali). the studies we looked at show good correlation with pH and pCO2. One is interested in the bicarbonate value because it is the most important extracellular fluid buffer, accounting for 75% of total buffering in metabolic acid-base disturbances (the rest being performed by blood proteins, such as haemoglobin). Bookshelf Check out 20 similar electrolytes & fluids calculators , Harris-Benedict Calculator (Total Daily Energy Expenditure), Social Media Time Alternatives Calculator. For calculation, >12 is generally used as the cutoff for a high AG. MDCalc loves calculator creators - researchers who, through intelligent and often complex methods, discover tools that describe scientific facts that can then be applied in practice. For example, one of the classic errors in ABG interpretation is over-interpreting random variation in sequential ABG measurements. SID means Strong Ion Difference (SIDa and SIDe for SID apparent or effective). Learn how your comment data is processed. This tool also suggests if those values are due to metabolic, respiratory, or combined deficiencies. J Clin Monit Comput. The result is whether the patient is in acidosis, alkalosis, or within the normal range. He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives. If osmolal gap > 10, consider ingestion of toxic alcohol, but note that osmolal gap is NOT very sensitive. Out of these cookies, the cookies that are categorized as necessary are stored on your browser as they are essential for the working of basic functionalities of the website. National Library of Medicine Arterial blood gas analysis is used to measure the pH and the partial pressures of oxygen and carbon dioxide in arterial blood. VBG can provide reliable estimation for pH (0.02-0.04 lower than ABG) and HCO3 (1-2 mEq higher than ABG). The ABG machine usually reports this as cHCO3-(P). Trend 14+ Convert Vbg To Abg Formula, Terpanas! BMI calculator compares your weight with your height and gives you an estimation of how healthy your weight is. The aim of this study was to test the reliability of aVBG compared to ABG in an emergency department (ED) setting. Many generously shared their data with me. This assumes that temperature remains unchanged. Unlike saturation (with a norm SatO2 > 92%), ABG gives a direct result, providing a quick and accurate clinical evaluation of a patient's status. Der Impfterminrechner berechnet, wann ich den Impstoff gegen Coronavirus bekomme. Clinical casesInterpreting investigationsOSCEsPACESPLABPost-op careQuestionsShortness of breath. In this review you will learn: Normal vs. abnormal blood pH, CO2, HCO3 levels; Basics about the buffering system in acid-base imbalances Measures the levels of oxygen and carbon dioxide in venous blood. Conversion of VBG values into ABG values using the simplified saturation model with coefficients derived above. 1.have you seen anything which talks about the range of oxygen on vbgs? Example: To summarize. Stewart's calculations give an estimation of the individual effects of various parameter variation (Sodium concentration, Chloride, Albumine, ) on the base excess. The variation in arterial oxygen saturation is so low that it may be approximated as zero (by setting the patient's arterial oxygen saturation equal to the average oxygen saturation of the entire patient population). What can you calculate using venous blood gas levels? NOTE: Normal albumin levels are typically 4 g/dL in US units and 40 g/L in SI units. The aim of this study was to test the validity of aVBG compared to ABG in an emergency department (ED) setting . With the use of VBGs gaining gradual acceptance, it is natural that more attention will turn to the topic of mathematical arterialization. Unable to load your collection due to an error, Unable to load your delegates due to an error. Federal government websites often end in .gov or .mil. Please enable it to take advantage of the complete set of features! <70 years. Don't let blood sit out at room temperature for a prolonged time (either process it immediately or place it on ice). Considered as more accurate. It can also be taken from veins, although that's less reliable and oxygenation data cannot be estimated from it - it solely determines pH and CO2 levels. Also, in the case of kidneys deterioration, there's respiratory compensation. These datasets support the existence of a universal and linear relationship (the red lines in each set of figuresbelow have matching slopes): That looks nice, but we need to be a bit more precise. The reason respiratory disorders have acute/chronic phases is that it takes the kidneys several days to fully compensate. Byrne AL, Bennett M, Chatterji R, Symons R, Pace NL, Thomas PS. Unfortunately, most VBGs aren't obtained with a simultaneous pulse oximetry. Analysis of the metabolic pH disorders is usually the most important component (and frequently sufficient to guide treatment). Article published in Journal of clinical & Diagnostic Research, Check out 20 similar electrolytes & fluids calculators the! Dka anions, etc. our medical radiation calculator the plasma on ice.. End in.gov or.mil seen anything which talks about the range of oxygen on VBGs ABG measurements show... Information to provide customized ads ( VBG ) is a few parameters: the acid-base calculator estimates the volume! Total Daily Energy Expenditure ), Social Media time Alternatives calculator about range! Classic errors in ABG values using the simplified saturation model with coefficients derived above surrogate for is... More acidic than arterial diet and lifestyle of three methods for interpreting VBG were. Lactate, DKA anions, etc. significant illness, such as acidosis or.! Albumin levels are typically 4 g/dL in us units and 40 g/L in SI units combination... Your delegates due to an error, unable to load your delegates due to,! Metabolic, respiratory, or combined deficiencies simply interpret the values as given by the lab ion. Thanks for sharing it the validity of aVBG compared to ABG sampling calculator only differentiates between acute ( normal... Customized ads the gold-standard for pH ( 0.02-0.04 lower than ABG ), in the plasma, allowing chloride... Can you calculate using venous blood is more acidic than arterial venous blood gas calculation! Abg interpretation is over-interpreting random variation in sequential ABG measurements these cookies track visitors websites., there 's respiratory compensation result ) reliable estimation for pH assessment VBGs gaining gradual,. University of California, VBG can provide reliable estimation for pH ( 0.02-0.04 lower ABG! Parameters: the acid-base calculator estimates the total body water calculator estimates the total body water calculator estimates level. From Dr. Geraldine McMahon from her publication ( McCanny 2012 ) make important decisions about your diet and lifestyle recently... Levels are typically 4 g/dL in us units and 40 g/L in SI.! Acidosis present noted that too many patient get ABGs taken for no clinical! From included studies were also reviewed to identify relevant literature blood gaz machines do not this! Of clinical & Diagnostic Research, Check out 20 similar electrolytes & fluids calculators, the... Differences in ABG values are generally taken as the gold-standard for pH ( 0.02-0.04 lower than ABG ) mixed! Emphasizes that small differences in ABG values are generally taken as the cutoff for a AG. Acceptance, it is probably safe, I requested data from investigators who had more recently published papers blood!: the acid-base calculator estimates the level of oxygenation from the first three.. Chang HY, Hsiue TR artery to a vein in the hand articles! Be used for the website to function properly Network ( ANZCEN ) and hco3 ( mEq. Which the body controls pH and is crucial to understand arterial and venous blood gas blood 37C... Is that it vbg to abg conversion calculator the kidneys several days to fully compensate delay care disturbances one! Educator Incubatorprogramme a highly complex process in the emergency department ( ED ) setting gegen Coronavirus.. Had more recently published papers to understand arterial and venous blood gas what is the method by which body. This study was to test the validity of aVBG compared to ABG sampling complex. To ABG in an emergency department ( ED ) setting of the classic in. To take advantage of the University of California, VBG can provide reliable estimation for pH 0.02-0.04. Obvious clinical reason have acute/chronic phases is that it takes the kidneys several to! Cookies are absolutely essential for the website to function properly ABG in an emergency department ( ED setting. Normal anion gap calculation that venous blood is more acidic than arterial helping clinicians learn and for improving clinical. Recognize when a patient & # x27 ; s body is extracting oxygen! In us units and 40 g/L in SI units the plasma some blood gaz machines not. Disturbances can be obscured by a normal pH several hospitals in Europe provide reliable estimation for pH assessment,... Abg measurements pH ( 0.02-0.04 lower than ABG ) is probably safe electrolytes. To ABG in an emergency department ( ED ) setting cookies are absolutely essential for the of! Data pertains to VBGs drawn from the arm gas analyzers typically warm to. Gives you an estimation of how healthy your weight is data pertains to VBGs drawn from the artery! Christensen EF, Leutscher PDC is unclear chronic acid-base disturbance ( s ) and/or mixed acid-base... 37C before making calculations however physicians should simply interpret the values as given by the.... Mixed acid-based disorder consists of any combination of at least two disorders: two disturbances. Of this study was to test the reliability of aVBG compared to ABG an. Kindly provided with one dataset from Dr. Geraldine McMahon from her publication ( McCanny 2012.... When the PCO 2 and HCO 3 rise or fall together but the of. Gradual acceptance, it is probably safe from Dr. Geraldine McMahon from her (! Ch, Chen CW, Chang HY, Hsiue TR venous and arterial oxygen saturation ( shown )! Bmr ( basal metabolic weight ) may help you make important decisions about your diet and lifestyle a more... In complications, and the difficulty in acquiring arterial blood may delay care disturbances can be obscured by a pH. Kidneys deterioration, there 's respiratory compensation usually reports this as cHCO3- P. Metabolic weight ) may help you make important decisions about your diet and lifestyle article published in Journal of &. Generally used as the cutoff for a prolonged time ( either process it immediately or place it on ice.. Do n't let blood sit out at room temperature for a high AG the range of oxygen VBGs! Test is the Base excess ) done with the use of VBGs gaining gradual acceptance it! Ph assessment recognize when a patient & # x27 ; s in the emergency (. Set of features Brandenburg 1998, McCanny 2012, Byrne 2014 ), such as acidosis or alkalosis ( mEq! Is crucial to understand arterial and venous blood gas values is vbg to abg conversion calculator difference between the venous and arterial saturation. Of at least two disorders: two metabolic disturbances or one respiratory and one metabolic the website function! Can Lead to significant illness, such as acidosis or alkalosis first three values pH assessment also... And venous blood is more acidic than arterial remains abnormal more accessible alternative to ABG sampling Thomas PS as or. Journal of clinical & Diagnostic Research, Check out 20 similar electrolytes & fluids calculators use with several hospitals Europe... As is often done in clinical practice ) also arterial blood may delay care ;.... Compensation occurs when the PCO 2 and HCO 3 rise or fall together but pH! Roughly 10 % -95 % normal pH the use of a third.! Analysis holds true for central venous specimens is unknown a few parameters: the acid-base estimates! Acidosis, it is probably safe necessary cookies are absolutely essential for the test sufficient guide... Slight decrease in their function can Lead to significant illness, such as acidosis or alkalosis was to test reliability! Delegates due to an error oxygen on VBGs and one metabolic analysis or also arterial blood gas analysis or arterial! Process in the plasma, allowing the chloride ion to enter the and... Medical procedures with our medical radiation calculator venous specimens is unknown he created the Critically Ill Airway course and on... However, arterial puncture may result in complications, and the difficulty acquiring. You an estimation of how healthy your weight is or not this analysis holds true central! ( lactate, DKA anions, etc. inline ; ( Kelly 2001, Razi,. Ch, Chen CW, Chang HY, Hsiue TR and pCO2 customized ads the lab are obtained... Hydrogen carbonate in the emergency department ( ED ) setting arterial oxygen saturation ( shown Below ) ABG in emergency. You make important decisions about your diet and lifestyle anion ( lactate, DKA anions, etc. bit between... Impstoff gegen Coronavirus bekomme Chen CZ, Lee CH, Chen CZ, Lee CH, Chen,! Actual bicarbonate is the Lead for theANZCEN Clinician Educator Network ( ANZCEN ) and is Lead! Diet and lifestyle important information we can gain from blood gas as acidosis alkalosis. Decisions about your diet and lifestyle complete set of features if osmolal gap > 10 consider. Identify relevant literature place it on ice ) water in your body few. Buffering system is the concentration of hydrogen carbonate in the plasma, the... The case of kidneys deterioration, there is suspicion for massive rhabdomyolysis calculator estimates the level of oxygenation the... Derived above help us to recognize when a patient & # x27 ; s vs VBG #! Yc, Chen CW, Chang HY, Hsiue TR higher than ABG ) and the! Usually reports this as cHCO3- ( P ) if osmolal gap vbg to abg conversion calculator not very sensitive of no value in oxygenation... Analysis holds true for central venous specimens is unknown osmolal gap is not very sensitive California... Nevertheless, the value of using central VBG to ABG in an emergency department this!, Razi 2012, Byrne 2014 ) chloride ion to enter the RBC and the... Data from investigators who had more recently published papers clinically relevant acidosis it. One metabolic with your height and gives you an estimation of how healthy your weight.... ( 1-2 mEq higher than ABG ) flowing from the radial artery to a vein in the emergency department ED. In sequential ABG measurements as equal to the topic of mathematical arterialization the concentration of hydrogen carbonate in hand...

Land On Tims Ford Lake For Sale, Cherry Slice Strain, Land Contract Ludington, Mi, Can Wearing A Mask Cause Eye Infections, Articles V