From the Guidelines

Yes, acid-base disturbances can be calculated from venous Basic Metabolic Panel (BMP) laboratory values.

The venous pH, which is usually 0.03 units lower than arterial pH, can be used to monitor resolution of acidosis 1.
The anion gap can also be calculated from venous BMP values and used to monitor resolution of acidosis 1.

Venous pH: can be used to monitor resolution of acidosis, with a target value of >7.3 for resolution of DKA 1.
Bicarbonate: can be used to monitor resolution of acidosis, with a target value of ≥18 mEq/l for resolution of DKA 1.
Anion gap: can be calculated from venous BMP values and used to monitor resolution of acidosis 1.

In patients with diabetic ketoacidosis (DKA), venous pH and anion gap can be used to monitor resolution of acidosis 1.
In patients with chronic renal failure, serum bicarbonate should be monitored regularly and correction of metabolic acidemia should be a goal of management 1.
In patients with traumatic haemorrhagic shock, initial base deficit obtained from peripheral venous blood can be used as a predictor of mortality 1.

From the Research

Acid-base disturbances can be calculated from venous Basic Metabolic Panel (BMP) laboratory values, but with certain limitations and considerations 2, 3, 4.
A study published in Nephron in 2018 found that central venous blood gas (VBG) sampling may be an alternative, less-invasive diagnostic tool for detecting acid-base disturbances in critically ill patients, with high sensitivity and percent agreement compared to arterial blood gas (ABG) 2.
Another study published in Acta anaesthesiologica Scandinavica in 2025 compared venous and calculated blood gas values to arterial values in critically ill patients and found similar congruency of venous and calculated pH and PCO2 values to arterial values, but the method was unreliable in a patient suspected of severe metabolic acidaemia 3.

The use of venous BMP values to calculate acid-base disturbances may not always be accurate, especially in patients with severe acid-base disturbances or those requiring vasopressor support 3, 4.
A study published in the American journal of respiratory and critical care medicine in 2000 found that base excess and plasma bicarbonate may not detect complex metabolic acid-base disturbances, especially in patients with hypoalbuminemia 5.
The correlation between serum and arterial blood gas bicarbonate in patients admitted to the intensive care unit was found to be strong, but with some discrepancies, and neither ABG nor BMP bicarbonate values had strong accuracy for diagnosing acidemia 4.

Clinicians can use venous BMP values to calculate acid-base disturbances, but should be aware of the potential limitations and consider using ABG or other diagnostic tools in certain situations 2, 3, 4.
The diagnosis and treatment of acid-base disturbances should be based on a comprehensive evaluation of the patient's clinical condition, laboratory results, and other relevant factors 6, 5, 4.