Arterial Blood Gases
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Transcript of Arterial Blood Gases
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Analysis Of ABG ABG Arterial blood gases
pH
disorder
3 different disorders 2 metabolic respiratory
normal values
pH=7.35 - 7.45 PaCO2 = 35 - 45 mmHg PaO2 = 80 - 100 mmHg HCO3 = 22 - 26 mlEq/L
anion gap HAGMA High anion gap metabolic acidosis
anion gap anion gap
measured cations and anions
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acidosis accumulation of non volatile acids or loss of bicarbonate
Na-(Cl+HCO3) =8-14 mEq/L
anions and cations anion gap
balance cations=anions Na+unmeasured cations=(Cl +HCO3)+unmeasured anions
Na-(Cl+HCO3)=UA-UC anion gap UA-UC
albumin albumin 50% anion gap 75% ABG
Albumin hypoalbuminaemia
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STEP 1
- anion gap AG = Na-(Cl+HCO3) normal value =9-16
anion gap 20 acidosis
20 HAGMA is most likely present HAGMA=high anion gap metabolic acidosis ABG pH anion gap 30 high anion gap metabolic acidosis pH and HCO3
anion gap metabolic disorder
- delta gap delta gap =AG-12 delta gap HCO3
delta gap+HCO3
26mmol/L coexisting metabolic alkalosis
24 mmol/L coexisting NAGMA (normal anion gap metabolic acidosis(
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24-26 metabolic disorder HAGMA
HAGMA metabolic disorder
2STEP
Values disorders
pH 735 acidaemia pH 745 alkalaemia pH HCO3 metabolic acidosis pH PaCO2 respiratory acidosis pHHCO3 metabolic alkalosis
pH PaCO2 respiratory alkalosis respiratory disorder
3STEP Disorder respiratory disorder acute or chronic
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metabolic acidosis : PaCO2=(1.5HCO3+8)+/-2 metabolic alkalosis : PaCO2=40+0.7(measured HCO3-24( Respiratory acidosis : *Acute : HCO3 increases 1mmol/L for every 10 mmHg increase in PaCO2. ..and pH decreases 0.008 per 1mmHg inc. in PaCO2 *Chronic : HCO3 inc. 3.5 mmol/L for every 10 mmHg inc. in PaCO2 and pH decrease 0.003 per 1 mmHg inc. in PaCO2 Respiratory alkalosis : *acute : HCO3 decr. 2 mmol/L for every 10 mmHg decr. in PaCO2 pH incr. 0.008 per 1 mmHg decrease in PaCO2 *chronic : HCO3 decrease 5mmol/L for every 10 mmHg increase in PaCO2 and pH increase 0.003 per 1mmHg decr.in PaCO2
full analysis ABG
diagnosis of any disorder