ASSIGNMENT OF ‘CLINICAL LABORATORY

ROTATIONS-I’

Name : Maira Iqbal

Registration Number : DMLS02163080
Student Number : 70085601
Semester : 9th Semester
Course Code : MLTLR-1502
Assignment Topic :“Arterial Blood Gases(ABGs) Analyzer”

University Institute of Medical Laboratory Technology ,

Faculty of Allied Health Sciences,
The University of Lahore.

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 INDEX
Sr.No. Topic Page Number

1. What is Arterial Blood Gases(ABGs) Page 3

analysis?

2. Clinical significance of ABGs Page 3

3. Principle of ABGs analyzer Page 3-4

4. Working parts of ABGs analyzer Page 5

5. Maintenance of ABGs analyzer Page 6

6. Quality Control of ABGs analyzer Page 6-7

7. Interpretation of ABGs Page 8

8. Bibliography Page 9

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 Arterial Blood Gases(ABGs) analyzer
What is Arterial Blood Gases analysis?
An ABG is a blood test that measures the acidity, or pH, and the levels of
oxygen (O2) and carbon dioxide (CO2) from an artery.² The test is used to
check the function of the patient’s lungs and how well they are able to move
oxygen into the blood and remove carbon dioxide.  This test is commonly
performed in the ICU and ER setting; however, ABGs can be drawn on any
patient on any floor depending on their diagnosis. (www.nurse.org)

Clinical significance of Arterial Blood Gases(ABGs) test

ABGs are drawn for a variety of reasons. These may include concern for:

 Lung Failure
 Kidney Failure
 Shock
 Trauma
 Uncontrolled diabetes
 Asthma 
 Chronic Obstructive Pulmonary Disease (COPD)
 Hemorrhage
 Drug Overdose
 Metabolic Disease
 Chemical Poisoning
 To check if lung condition treatments are working
(www.nurse.org)

Principle of ABGs analyzer

Blood is collected from the patient and introduced into the analyser.The
analyser aspirates the blood into a measuring chamber which has Ion Selective
Electrodes (IE electrodes that are sensitive only to the measurement of
interest). The pH electrode compares a potential developed at the electrode
tip with a reference potential, the resulting voltage is proportional to the
concentration of hydrogen ions, [H+]. The pCO electrode is a pH electrode
2
with a Teflon or silicone rubber CO semi permeable membrane covering the
2

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tip. CO combines with H O in the space between the membrane and the
2 2
electrode tip to produce free hydrogen ions in proportion to the partial
pressure of CO . The voltmeter, although actually measuring [H+], is
2
calibrated in pCO .
2
For pO , oxygen permeates a polypropylene membrane and reacts
2
chemically with a phosphate buffer. The O combines with water
2

in the buffer, producing current in proportion to the number of oxygen

molecules. The current is measured and expressed as partial pressure of
oxygen. After measurement, the blood is automatically expelled into a waste
container and the sample path is cleaned, ready for the next sample.
(www.researchgate.com)

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 Figure: ABG analyzer principle,
Adapted from
https://www.researchgate.net/pu
blication/329983426_blood_gas
_analyzer_principle

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Working parts of ABGs analyzer

The working parts of an ABG analyzer on the outside and inside consists of
the following :

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 Figure: ABG analyzer parts,
Adapted from https://fccid.io/OELISMART300A/User-Manual/i-Smart-300-
Analyzer-user-manual-draft-3-2911252

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Figure: Inside an ABG analyzer. Adapted from

https://slideplayer.com/slide/12822345/

Maintenance of ABGs analyzer

To maintain an ABG analyzer, it must be used in a proper way. Some of the
steps to ensure good maintenance of the blood gas analyzer are

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 • Never aspirate an arterial blood gas sample or mix it if it contains air
bubbles
• Do not use any gas analyzer that is not or cannot be calibrated at two
points in the range of expected results
• Do not use any pH / blood gas analyzer for reporting results if the most
recent quality control results violate any of the rules for acceptable
performance
• A bio-medical engineer should be hired to evaluate the ABG analyzer
from time to time.
• When establishing quality assurance programs, an assessment of the
competency of the technician(s) must be performed initially and
periodically thereafter (www.media.lanecc.edu)

Quality Control (QC) of ABGs analyzer

To ensure consistent reliable results, the blood gas analyzer should be part of a
quality assurance program that monitors, documents, and regulates the
accuracy of the analyzer. Internal quality control measures may consist of
calibration, quality control and maintenance schedules, comparing samples to
lab equipment, and external proficiency testing. The newest generation of
point-of-care analyzers will autocalibrate, analyze quality control samples,
and detect errors. (www.sciencedirect.com)

While QC is essential for all laboratory measurements, QC assessments for

blood gas and critical care measurements are particularly important because
patients requiring these measurements are critically ill and in need of
immediate treatment based on these test results. 
 calibrate or verify calibration according to the manufacturer’s
specifications and frequency, 
 test one sample of control material each 8 hours of testing using a
combination of control materials that include both low and high values
on each day of testing, 
 test one QC sample each time patient samples are tested unless
calibration is automatically verified every 30 minutes 
(www.acutecaretesting.org)

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Quality control processes focus on eliminating errors in:
o Sample collection (pre-analytical phase)

o Sample measurement (post-analytical phase)

o Reporting (post analytical phase)

Pre-analytical errors the need to be avoided are

 Air contamination
 Assess the sample for any obvious pre-analytical errors (air
bubbles or clots
 Excess anticoagulant
 Continued blood metabolism
 Be proficient in sampling techniques/equipment used to draw
from various sites
Analytical phase involves key elements such as
 Standards used to calibrate ABG machines include
precision gases and buffer solutions with know values
for pH, PCO2, and PO2
 Calibration involves adjusting the analyzer to ensure
that its response is accurate and linear
 Devices with automated calibration require calibration
verification by analyzing a pre-prepared control media
with known measurement values.
 Sample testing must follow protocol aligned with
manufacturer operation specifications
Post analytical phase
 Ensure proper interpretation of the result
 Alert or panic values should be pre-established for
notification and follow-up (www.media.lanecc.edu)

Interpretation of Arterial Blood Gases(ABGs)

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The first value you should look at is the pH to determine if the patient is in the
normal range, above, or below. If a patient’s pH > 7.45, the patient is in
alkalosis. If the pH < 7.35, then the patient is acidosis.
The typical normal values of different aspects of blood gas are,
 pH: 7.35-7.45
 Partial pressure of oxygen (PaO2): 75 to 100 mmHg
 Partial pressure of carbon dioxide (PaCO2): 35-45 mmHg
 Bicarbonate (HCO3): 22-26 mEq/L
 Oxygen saturation (O2 Sat): 94-100% 
 Na+ : 135-145 mmol/L
 K+ : 3.5-5.2 mmol/L

Bibliography

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 1. https://nurse.org/articles/arterial-blood-gas-test/#:~:text=What%20is
%20an%20Arterial%20Blood,blood%20and%20remove%20carbon
%20dioxide.

2. https://www.researchgate.net/publication/329983426_blood_gas_analyzer
_principle

3. https://fccid.io/OELISMART300A/User-Manual/i-Smart-300-Analyzer-user-
manual-draft-3-2911252

4. https://slideplayer.com/slide/12822345/

5. https://www.sciencedirect.com/topics/nursing-and-health-
professions/blood-gas-analyzer

6. https://acutecaretesting.org/en/articles/the-importance-of-quality-control-
qc-to-quality-blood-gas-testing

7. 7.
8. https://www.media.lanecc.edu/ driscolln/Perform_Quality _Control

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