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Arterial blood Gases

Acid-base disorders


Respiratory acidosis (excess
CO2 retention)
pH < 7.35 (SI, < 7.35), HCO3 > 26 mEq/L Central nervous system depression Diaphoresis, headache, tachycardia,
(SI, > 26 mmol/L) (if compensating), from drugs, injury, or disease confusion, restlessness, apprehension
PaCO2 > 45 mm Hg (SI, > 5.3 kPa) Asphyxia
Hypoventilation due to pulmonary,
cardiac, musculoskeletal, or
neuromuscular disease
Postoperative pain
Abdominal distention

Respiratory alkalosis (excess

CO2 excretion)
pH > 7.45 (SI, > 7.45), HCO3 < 22 mEq/L Hyperventilation due to anxiety, Rapid, deep breathing; paresthesia; light-
(SI, < 22 mmol/L) (if compensating), pain, or improper ventilator settings headedness; twitching; anxiety; fear
PaCO2 < 35 mm Hg (SI, < 4.7 kPa) Respiratory stimulation caused by
drugs, disease, hypoxia, fever, or
high room temperature
Gram-negative bacteremia
Compensation for metabolic acidosis
(chronic renal failure)

Metabolic acidosis (HCO3 loss, acid

pH < 7.35 (SI, < 7.35), HCO3 < 22 mEq/L HCO3 depletion due to renal Rapid, deep breathing; fruity breath;
(SI, < 22 mmol/L), PaCO2 < 35 mm Hg (SI, disease, diarrhea, or small-bowel fatigue; headache; lethargy; drowsiness;
< 4.7 kPa) (if compensating) fistulas nausea; vomiting; coma (if severe)
Arterial blood Gases

Excessive production of organic

acids due to hepatic disease;
endocrine disorders, including
diabetes mellitus, hypoxia, shock;
and drug intoxication
Inadequate excretion of acids due
to renal disease

Metabolic alkalosis (HCO3

retention, acid loss)
pH > 7.45 (SI, > 7.45), HCO3 > 26 mEq/L Loss of hydrochloric acid from Slow, shallow breathing; hypertonic
(SI,> 26 mmol/L), PaCO2 > 45 mm Hg (SI, prolonged vomiting or gastric muscles; restlessness; twitching; confusion;
> 5.3 kPa) suctioning irritability; apathy; tetany; seizures; coma
Loss of potassium due to increased (if severe)
renal excretion (as in diuretic
therapy) or steroid overdose
Excessive alkali ingestion
Compensation for chronic
respiratory acidosis

Fischbach, F., & Dunning, M. B. (2014). A manual of laboratory and diagnostic tests (9th ed.). Philadelphia, PA: Wolters Kluwer.