Arterial Blood Gas > Test measures the acidity (pH) and the levels of oxygen and carbon

dioxide in the blood from an artery. > Used to check how well your lungs are able to move oxygen into the blood and remove carbon dioxide from the blood. > Uses blood drawn from an artery, where the oxygen and carbon dioxide levels can be measured before they enter body tissues. > An ABG measures: a. Partial Pressure of Oxygen (PaO2) - This measures the pressure of oxygen dissolved in the blood and how well oxygen is able to move from the airspace of the lungs into the blood. b. Partial pressure of carbon dioxide (PaCO2). - This measures how much carbon dioxide is dissolved in the blood and how well carbon dioxide is able to move out of the body. c. pH - The pH measures hydrogen ions (H+) in blood. The pH of blood is usually between 7.35 and 7.45. A pH of less than 7.0 is called acid and a pH greater than 7.0 is called basic (alkaline). So blood is slightly basic. d. Bicarbonate (HCO3) - Bicarbonate is a chemical (buffer) that keeps the pH of blood from becoming too acidic or too basic. e. Oxygen content (O2CT) and oxygen saturation (O2Sat) values. - O2 content measures the amount of oxygen in the blood. Oxygen saturation measures how much of the hemoglobin in the red blood cells is carrying oxygen (O2). > Blood is taken from a heparinized syringe. > Normal Values: pH PaCO2 HCO3 O2 = = = = 7.35 35 22 95 7.45 45 26 100 mmHg mEq/L %

> The ABG test is done for the following reasons: a. Check for severe breathing problems and lung diseases, such as asthma, cystic fibrosis, or chronic obstructive pulmonary disease (COPD). b. See how well treatment for lung diseases is working. c. Find out if you need extra oxygen or help with breathing (mechanical ventilation). d. Find out if you are receiving the right amount of oxygen when you are using oxygen in the hospital. e. Measure the acid-base level in the blood of people who have heart failure, kidney failure, uncontrolled diabetes, sleep disorders, severe infections, or after a drug overdose. > The ABG has 4 abnormalities: 1. Metabolic Acidosis 2. Metabolic Alkalosis 3. Respiratory Acidosis 4. Respiratory Alkalosis > Henderson Hasselbalch Relationship

> Example of Disorders under ABG Respiratory Acidosis Acute Bronchitis Emphysema ARDS Atelectasis Pneumonia Asthma Respiratory Alkalosis Hyperventilation Fever Increase ICP Salicylic Poisoning Intensive Exercise Hypoxia Increase Altitude Drug Overdose Pneumonia Metabolic Acidosis Diabetic Ketoacidosis Graves Disease Infection Lactic Acidosis Renal Failure Prolonged Starvation Hepatitis Burns Metabolic Alkalosis Potassium Deficiency Fistulas GI Suctioning Diuretic Therapy Renal Failure Drug Ingestion

5 Easy Steps in Assessing ABGs 1. Classify the Serum pH (7.35 7.45) 7.45 = Alkalemia 7.35 = Acidemia

2. Assess PaCO2 / Respiratory (35 45 mmHg) 45 = Acidemia 35 = Alkalemia 3. Assess HCO3 / Metabolic (22 26 mmHg) 26 = Alkalemia 22 = Acidemia 4. Determine the presence of compensation a. Fully Compensated pH Normal PaCO2 Abnormal HCO3 Abnormal b. Partially Compensated pH Abnormal PaCO2 Abnormal HCO3 Abnormal c. Uncompensated pH Abnormal PaCO2 Abnormal HCO3 Abnormal 5. Identify primary disorder a. First Name: Degree of Compensation b. Middle Name: Presence of Abnormality, either PaCO2 (Respiratory) or HCO3 (Metabolic) c. Last Name: To which side is the pH compensating
Either is Abnormal. 1 must be Abnormal and the other should be normal. PaCO2 & HCO3 are both Abnormal in opposite directions. 1 must be acidic and the other should be alkaline.