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    ABG Interpretation

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    anaesthesiologist100
    This document provides guidance on interpreting arterial blood gases (ABGs). It first reviews normal pH, PaCO2, and HCO3 levels. It then instructs the reader to first examine the pH to identify acidosis or alkalosis, then examine the PaCO2 as the respiratory component and HCO3 as the metabolic component. Comparing these values can indicate a respiratory or metabolic disorder, or compensation between systems. Worked examples are provided to demonstrate identifying respiratory acidosis, alkalosis, metabolic acidosis, and alkalosis, as well as cases of partial and full compensation between systems.

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    ABG Interpretation

    Uploaded by

    anaesthesiologist100
    660 views44 pages
    This document provides guidance on interpreting arterial blood gases (ABGs). It first reviews normal pH, PaCO2, and HCO3 levels. It then instructs the reader to first examine the pH to identify acidosis or alkalosis, then examine the PaCO2 as the respiratory component and HCO3 as the metabolic component. Comparing these values can indicate a respiratory or metabolic disorder, or compensation between systems. Worked examples are provided to demonstrate identifying respiratory acidosis, alkalosis, metabolic acidosis, and alkalosis, as well as cases of partial and full compensation between systems.

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    ABG

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    This document provides guidance on interpreting arterial blood gases (ABGs). It first reviews normal pH, PaCO2, and HCO3 levels. It then instructs the reader to first examine the pH to identify acidosis or alkalosis, then examine the PaCO2 as the respiratory component and HCO3 as the metabolic component. Comparing these values can indicate a respiratory or metabolic disorder, or compensation between systems. Worked examples are provided to demonstrate identifying respiratory acidosis, alkalosis, metabolic acidosis, and alkalosis, as well as cases of partial and full compensation between systems.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    660 views44 pages

    ABG Interpretation

    Uploaded by

    anaesthesiologist100
    This document provides guidance on interpreting arterial blood gases (ABGs). It first reviews normal pH, PaCO2, and HCO3 levels. It then instructs the reader to first examine the pH to identify acidosis or alkalosis, then examine the PaCO2 as the respiratory component and HCO3 as the metabolic component. Comparing these values can indicate a respiratory or metabolic disorder, or compensation between systems. Worked examples are provided to demonstrate identifying respiratory acidosis, alkalosis, metabolic acidosis, and alkalosis, as well as cases of partial and full compensation between systems.

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    ABG

    ABG Interpretation
    Interpretation
    Dr. Tarek Ashoor
    M.D. Anaesthesiology and Intensive care
    Ain Shams University
    Purpose of ABG
    • Assess degree to which lungs are
    able to provide adequate oxygen &
    remove CO2 & degree to which the
    kidneys are able to reabsorb or
    excrete HCO3
    You Must Know What is
    Normal to be Able to Know
    What is Abnormal
    • pH = 7.35 to 7.45
    • PaC02 = 35 to 45 mm Hg
    • PaO2 = 80 to 100 mm Hg
    • HCO3 = 22 – 26 mEq/l
    What You Must Look at to
    Interpret ABGs
    • What is the definition of
    pH, pka?
    • Look at Your pH

    • Is it normal?
    • Is it high ?
    • Is it low?
    Examples

    • pH = 7.36
    • pH = 7.23
    • pH = 7.47
    • A high pH indicates alkalosis
    • A low pH indicates acidosis
    Look at Your PaCO2

    • Is it normal ?
    • Is it high ?
    • Is it low ?
    • This is the respiratory component
    • An abnormality in the PaCO2 will
    indicate a respiratory problem
    Examples

    • PaCO2 = 40 mm Hg
    • PaCO2 = 23 mm Hg
    • PaCO2 = 48 mm Hg
    • A high PaCO2 indicates acidity
    • A low PaCO2 indicates alkalosis
    Now Look at Your HCO3

    • Is it normal ?
    • Is it high ?
    • Is it low ?
    • This is the metabolic component
    • An abnormality in the HCO3
    indicates a metabolic problem
    Examples

    • HCO3 = 25 mEq/l
    • HCO3 = 19 mEq/l
    • HCO3 = 32 mEq/l
    • A low HCO3 indicates acidity
    • A high HCO3 indicates alkalosis
    Interpreting ABGs
    1st Step Look at pH

    • Is it normal (7.35 to 7.45)


    • Does it reflect acidosis ( less than
    7.35)
    • Does it reflect alkalosis (greater
    than
    7.45)
    • Label accordingly
    Next Look at PaCO2

    • This is the respiratory component


    • Is it normal
    • Does it reflect alkalosis (less than 35)
    • Does it reflect acidosis (greater than
    45)
    • Label accordingly
    Next Look at the HCO3

    • This is the metabolic component


    • Is it normal
    • Does it reflect acidosis (less than 22)
    • Does it reflect alkalosis (greater than
    26)
    • Label accordingly
    Problems

    • pH of 7.33
    • PaCO2 of 40 mmHg
    • HCO3 of 20 mEq/L
    • What does this indicate
    • Break it down
    • pH = acidosis
    • PaCO2 = normal
    • HCO3 = acidosis
    • An abnormal HCO3 indicates a
    metabolic problem
    Metabolic Acidosis
    What are the causes and types?
    Problem

    • pH of 7.59
    • PaCO2 of 29 mm Hg
    • HCO3 of 24mEq/L
    • What does this indicate
    • Break it down
    • pH = alkalosis
    • PaCO2 = alkalosis
    • HCO3 = normal
    • An abnormal PaCO2 indicates a
    respiratory problem
    Respiratory Alkalosis
    • What are the causes?
    Problem

    • pH of 7.25
    • PaCO2 of 61 mmHg
    • HCO3 of 26 mEq/L
    • What does this indicate
    • Break it down
    • pH = acidosis
    • PaCO2 = acidosis
    • HCO3 = normal
    • An abnormal PaCO2 indicates a
    respiratory problem
    Respiratory Acidosis
    What are the causes?
    Problem

    • pH of 7.51
    • PaCO2 of 44mmHg
    • HCO3 of 56
    • What does this indicate
    • Break it down
    • pH = alkalosis
    • PaCO2 = normal
    • HCO3 = alkalosis
    • An abnormal HCO3 indicates a
    metabolic problem
    Metabolic Alkalosis
    • What are the causes?
    Compensation

    • Occurs as the body begins to


    correct the acid base imbalance
    • pH will be normal or near normal if
    total compensation
    • pH will be abnormal if partial
    compensation
    Compensation

    • Both the PaCo2 & HCO3 will be


    abnormal
    • Respiratory imbalances are
    compensated for by the renal system
    • Metabolic imbalances are
    compensated for by the respiratory
    system
    • What are the
    compansatory mechanisms
    you know?
    Example

    • • pH of 7.27
    • • PaCO2 of 27 mm Hg
    • • HCO3 of 10 mEq/l
    • • Note that both the PaCO2 & the
    • HCO3 are low
    • Low pH = acidosis
    • Low PaCO2 = alkalosis
    • Low HCO3 = acidosis
    • HCO3 corresponds with the pH
    • This is a metabolic problem
    • Metabolic acidosis with partial
    compensation
    Problems

    • pH of 7.52
    • PaCO2 of 47 mmHg
    • HCO3 of 36 mEq/L
    • What does this indicate
    • Break it down
    • pH = alkalosis
    • PaCO2 = acidosis
    • HCO3 = alkalosis
    • Which 2 go together
    • Metabolic Alkalosis with
    Partial Compensation
    Problems

    • pH of 7.45
    • PaCO2 of 50 mmHg
    • HCO3 of 33 meq/L
    • What does this indicate
    • Break it down
    • pH = normal
    • PaCo2 = acidosis
    • HCO3 = alkalosis
    • Your pH leans toward the alkalosis
    side
    • Fully Compensated Metabolic
    Alkalosis
    • All the way lead to:

    ROME
    Summary
    If you forget everything , please remember:
    PH change in the same direction
    as Pco2
    Metabolic
    PH change in an opposite direction
    to Pco 2

    Respiratory
    Summary
    Low ph + Low pco2 =Metabolic acidosis

    Low ph+high pco2 =Respiratory acidosis


    Summary
    High ph+ high pco2 =
    Metabolic alkalosis

    High ph + Low pco2 =


    Respiratory alkalosis
    THANKS

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