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. 2010 Apr;14(2):57-64.
doi: 10.4103/0972-5229.68215.

Interpretation of arterial blood gas

Pramod Sood  1 , Gunchan Paul, Sandeep Puri
Affiliations

Interpretation of arterial blood gas

Pramod Sood et al. Indian J Crit Care Med. 2010 Apr.

Abstract

Disorders of acid-base balance can lead to severe complications in many disease states, and occasionally the abnormality may be so severe as to become a life-threatening risk factor. The process of analysis and monitoring of arterial blood gas (ABG) is an essential part of diagnosing and managing the oxygenation status and acid-base balance of the high-risk patients, as well as in the care of critically ill patients in the Intensive Care Unit. Since both areas manifest sudden and life-threatening changes in all the systems concerned, a thorough understanding of acid-base balance is mandatory for any physician, and the anesthesiologist is no exception. However, the understanding of ABGs and their interpretation can sometimes be very confusing and also an arduous task. Many methods do exist in literature to guide the interpretation of the ABGs. The discussion in this article does not include all those methods, such as analysis of base excess or Stewart's strong ion difference, but a logical and systematic approach is presented to enable us to make a much easier interpretation through them. The proper application of the concepts of acid-base balance will help the healthcare provider not only to follow the progress of a patient, but also to evaluate the effectiveness of care being provided.

Keywords: ABG analysis; Anion gap; Approach to mixed disorders; Arterial blood gas interpretation; rules for rapid ABG analysis.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Correct method of mixing of the arterial sample with the anticoagulant in two dimensions to prevent stacking of red blood cells.
Figure 2
Figure 2
Flow diagram showing approach to hypoxemic respiratory failure
Figure 3
Figure 3
Approach to a patient with normal anion gap acidosis
See this image and copyright information in PMC

References

    1. Kellum JA. Making Strong Ion Difference the “Euro” for Bedside Acid-Base Analysis. Yearbook of Intensive Care and Emergency Medicine. Spr Ber Heid Publ. 2005;5:675.
    1. Phillips B, Peretz DI. In: National Committee for Clinical Laboratory Standards. villanova PA: NCCLS publication; 1985. Blood Gas Pre-analytical considerations. Specimen collection, Calibration, and Controls (proposed guidelines) NCCLS.
    1. Börner U, Müller H, Höge R, Hempelmann G. The influence of anticoagulation on acid-base status and blood-gas analysis. Acta Anaesthesiol Scand. 1984;28:277–9. - PubMed
    1. Hutchison AS, Ralston SH, Dryburgh FJ, Small M, Fogelman I. Too much heparin: possible source of error in blood gas analysis. Br Med J. 1983;287:1131–2. - PMC - PubMed
    1. Toffaletti J, Ernst P, Hunt P, Abrams B. Dry electrolyte-balanced heparinized syringes evaluated for determining ionized calcium and other electrolytes in whole blood. Clin Chem. 1991;37:1730–3. - PubMed

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