Arterial Blood Gas Analysis

A.Edward
Lourdes Roshan
Celestrians
What is Arterial Blood Gas Analysis?

Diagnostic test performed to

measure the pH(acidity) and the
levels of oxygen and carbon dioxide
in the blood from an artery.
 History

VARALARU MIGA MUKIYAM

190
0
First arterial puncture from Radial artery by
191 Hurter, German physician
2
W.C.Stadie, demonstrated that cyanosis
History of ABG

191
in critically ill patient results from
9
incomplete oxygenation of Hb
machines

195 Electrodes measuring PaO2 ,PaCO2,pH

0 developed
195 Invention of Platinum Oxygen
3 electrode(prototype) by Clark

196 -Development of commercial electrodes

0 -Several universities started using them

197 First automated Blood Gas Machine (ABL 1 from

3 Radiometer)
198 Commercial production of ABG machines from
6 other companies.
200
0
 When you need ABG?
1. Patient in mechanical ventilation
2. Determine Acid-base status of individual
3. In thoracic trauma or contusions to
determine whether ventilator required
or not.
4. Respiratory failure.
5. Open-heart surgery
6. Sleep studies
7. Management of premature neonates
Procedure
Gather Equipments
Allen test
Note the paleness!!!
Anaesthetic infusion
 What next
Tested as soon as possible
Transported in COLD Chain
Parameters changes:(Changes every
10 mins)
Parameter Uniced(37o C) Iced (4o C)

pH 0.01 0.001

PCO2 1mmHg 0.1mmHg

PO2 0.1% 0.001%

 Welcome to analysis
desk!!!!!
Main objectives:
Acid base status of the patient.
Oxygenation
CO2 elimination
 Normal values

Parameters Range

pH 7.35-7.45

PCO2 35-45 mmHg

HCO3- 22-26mEq/L

PO2 70-100mmHg

SaO2 93-98%
Playtime!!!
No perfection without
Practice!!!
 Case1
A 24 year-old woman is found down in a park by
some bystanders. The medics are called and,
upon arrival, find her with an oxygen saturation of
88% on room air and pinpoint pupils on exam.
She is brought to casuality where a room air
arterial blood gas is performed and reveals:
Parameters Values
pH 7.25
PCO2 60 mmHg
HCO3- 26 mEq/L
PO2 65 mmHg
 Case 2
A patient who is under mechanical
ventilation is being monitored
carefully and his ABG analysis test
gives the following values:
Parameters Values
pH 7.42
PCO2 48 mmHg
HCO3- 30 mEq/L
PO2 83 mmHg
 Case 3
Mr. Worried is a 52-year-old widow. He is
retired and living alone. He enters the ED
complaining of shortness of breath and
tingling in fingers.His is done ABG and
reveals:
Parameters Values
pH 7.48
PCO2 28 mmHg
HCO3- 13mEq/L
PO2 85 mmHg
 Case 4
A 26 yr old patient in ICU is having
the following ABG test values:

Parameters Values
pH 7.53
PCO2 35mmHg
HCO3- 27mEq/L
PO2 62mmHg
 Case 5
A 60 year old patient is brought into
the clinic by his family, ABG reveals
following values:
Parameters Values
pH 7.33
PCO2 25mmHg
HCO3- 12mEq/L
PO2 89mmHg
 Case 6
A 66 year old man had a
postoperative cardiac arrest. His ABG
reveals:
Parameters Values
pH 7.30
PCO2 68mmHg
HCO3- 28mEq/L
PO2 60mmHg
 Case 7
An 80 year old lady (wt 40 kgs) was
admitted to the Intensive Care Unit
following a motor vehicle accident.
Her ABG values are:
Parameters Values
pH 7.30
PCO2 68mmHg
HCO3- 28mEq/L
PO2 60mmHg
You do SEE!!! You just
dont OBSERVE!!!
-Sherlock
Holmes