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ABG ANALYSIS

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Ashok Badamali
Ashok Badamali

This document provides information on interpreting arterial blood gas (ABG) results, including: 1. It evaluates oxygenation by examining pO2 and SaO2 levels, ventilation by looking at pCO2, and acid-base balance using pH, HCO3, and BE measurements. 2. Specific acid-base disorders are identified by whether pH, pCO2, and HCO3 levels are above or below normal ranges, and the degree of compensation between the parameters. 3. Two sample ABG results are interpreted, with one showing fully compensated respiratory acidosis and the other showing mixed respiratory and metabolic acidosis.

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ABG DR ASHOK KUMAR BADAMALI
Lecture ? Evaluation of oxygenation ? Evaluation of Ventilation ? Evaluation of acid base balance ? ABG analysis
Test Result Unit ref PH 7.44 7.35 7.45 pCO2 26mmHg mmHg 34 45 pO2 73 mmHg 75 100 O2 (HB%) 95.1 95 100 HCO3 18.2 Meq/L 23 27 BE -5.2 Meq/L -2.4 2.3 FiO2
Evaluation of Oxygenation ? Po2 should be >60 mmHg/ tor ? SaO2 >90% ? SpO2 may or may not corelate SaO2 ? Haemoglobin ? FiO2 – fraction of inspired oxygen
Hypoxemia ? Low oxygen in blood ? Pao2 < 60 mmHg ? SaO2 < 90%
Test name Results Units Ref FiO2 35% pH 7.4 PCo2 26 PO2 73 HCO3 18.2 BE -5.4 O2 % 95.4
Evaluation of Ventilation (CO2 elimination) ? Co2 Production vs Elimination ? Tidal volume ? Respiratory rate ? Metabolic rate ? Fever ? Seizure
Hyperventilating Test name Results Units Ref FiO2 35% pH 7.4 PCo2 26 PO2 73 HCO3 18.2 BE -5.4 O2 % 95.4
Interpretation of ABG ? Normal ranges ? Po2 ≥ 60 ? PCO2 35-45 ? HCO3 22-26 ? pH - 7.35- 7.45 ? BE (-2) – (+2) ? Sao2 ≥ 90%
Base excess / deficit ? Reflects metabolic balance of the bicarbonate ? Deficit = loss of base may be a problem or a correction Excess = Gain of base may be a problem or a correction
Approach to Interpretation of ABG ? Acid –Base Status (pH) ? Respiratory status ( PCO2) ? Metabolic status ( HCO3) ? Degree of Compentation
Acid –Base Status (pH) ? > 7.45 - Alkaline ? < 7.35 - Acidic ? 7.35-7.45 - WNL
Respiratory status ? PCO2 < 35 mmHg – Respiratory Alkalosis ? PCO2 >45 mmHg – Respiratory Acidosis ? 35-45 WNL
Metabolic status ? HCO3 > 26 metabolic alkalosis ? HCO3 < 22 metabolic acidosis ? 22-26 WNL ? BE (-2) base deficit ? > 2 is base excess
compensation ? Uncompensated – the other parameter within the normal range and has not changed to fix the problem ? Partial Compensation– The other parameter is outside the normal range & pH is not within 7.35 -7.45 ? Full compensation – other parameter is outside normal range & pH is 7.35-7.45
Evaluating ABG ? Evaluate oxygenation ? Is the pH acid /alkaline ? Which direction CO2 move the pH ? Which direction HCO3 move the pH ? Name the disorder ? Is there compentaion ? Patrial / complete
Interpret ABG ? pH 7.39 - acid ? PCO2 -50 - acid ? HCO3 -29 fully compensated ? PO2 – 65 respiratory acidosis ? BE- + 4.7 ? HB- 8 ? FiO2 -21 ? SaO2 -90% - No hypoxemia
? pH- 7.22 ? pCO2- 50 ? HCO3- 20 ? PO2 -200 ? BE- (-8) ? SaO2 100% ? HB-15 ? FiO2 - 1
ABG ANALYSIS

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ABG ANALYSIS

  • 2. Lecture ? Evaluation of oxygenation ? Evaluation of Ventilation ? Evaluation of acid base balance ? ABG analysis
  • 3. Test Result Unit ref PH 7.44 7.35 7.45 pCO2 26mmHg mmHg 34 45 pO2 73 mmHg 75 100 O2 (HB%) 95.1 95 100 HCO3 18.2 Meq/L 23 27 BE -5.2 Meq/L -2.4 2.3 FiO2
  • 4. Evaluation of Oxygenation ? Po2 should be >60 mmHg/ tor ? SaO2 >90% ? SpO2 may or may not corelate SaO2 ? Haemoglobin ? FiO2 – fraction of inspired oxygen
  • 5. Hypoxemia ? Low oxygen in blood ? Pao2 < 60 mmHg ? SaO2 < 90%
  • 6. Test name Results Units Ref FiO2 35% pH 7.4 PCo2 26 PO2 73 HCO3 18.2 BE -5.4 O2 % 95.4
  • 7. Evaluation of Ventilation (CO2 elimination) ? Co2 Production vs Elimination ? Tidal volume ? Respiratory rate ? Metabolic rate ? Fever ? Seizure
  • 8. Hyperventilating Test name Results Units Ref FiO2 35% pH 7.4 PCo2 26 PO2 73 HCO3 18.2 BE -5.4 O2 % 95.4
  • 9. Interpretation of ABG ? Normal ranges ? Po2 ≥ 60 ? PCO2 35-45 ? HCO3 22-26 ? pH - 7.35- 7.45 ? BE (-2) – (+2) ? Sao2 ≥ 90%
  • 10. Base excess / deficit ? Reflects metabolic balance of the bicarbonate ? Deficit = loss of base may be a problem or a correction Excess = Gain of base may be a problem or a correction
  • 11. Approach to Interpretation of ABG ? Acid –Base Status (pH) ? Respiratory status ( PCO2) ? Metabolic status ( HCO3) ? Degree of Compentation
  • 12. Acid –Base Status (pH) ? > 7.45 - Alkaline ? < 7.35 - Acidic ? 7.35-7.45 - WNL
  • 13. Respiratory status ? PCO2 < 35 mmHg – Respiratory Alkalosis ? PCO2 >45 mmHg – Respiratory Acidosis ? 35-45 WNL
  • 14. Metabolic status ? HCO3 > 26 metabolic alkalosis ? HCO3 < 22 metabolic acidosis ? 22-26 WNL ? BE (-2) base deficit ? > 2 is base excess
  • 15. compensation ? Uncompensated – the other parameter within the normal range and has not changed to fix the problem ? Partial Compensation– The other parameter is outside the normal range & pH is not within 7.35 -7.45 ? Full compensation – other parameter is outside normal range & pH is 7.35-7.45
  • 16. Evaluating ABG ? Evaluate oxygenation ? Is the pH acid /alkaline ? Which direction CO2 move the pH ? Which direction HCO3 move the pH ? Name the disorder ? Is there compentaion ? Patrial / complete
  • 17. Interpret ABG ? pH 7.39 - acid ? PCO2 -50 - acid ? HCO3 -29 fully compensated ? PO2 – 65 respiratory acidosis ? BE- + 4.7 ? HB- 8 ? FiO2 -21 ? SaO2 -90% - No hypoxemia
  • 18. ? pH- 7.22 ? pCO2- 50 ? HCO3- 20 ? PO2 -200 ? BE- (-8) ? SaO2 100% ? HB-15 ? FiO2 - 1