ABG Quick Interpretation

Parameter Acidosis Normal Alkalosis Reflects

Acid/Base
pH < 7.35 7.35-7.45 > 7.45
Status of Body
Respiratory
pCO2 > 45 35-45 < 35
Component
Metabolic
HCO3 < 22 22-26 > 26
Component
Facts: Body will not overcompensate when it comes to acid/base balance so:
• pH midpoint is 7.4
• If pH on report is < 7.4 = original problem was acidosis in nature
• If pH on report is > 7.4 = original problem was alkalosis in nature

Examples:
1. pCO2 is High and pH is 7.37 = compensated Respiratory Acidosis because in spite of
high pCO2 which would indicate Acidosis the pH is within normal range indicating
that the metabolic component has kicked in and caused pH to shift more towards the
midpoint of 7.4
and therefore compensated for the respiratory acidosis.
2. pH is 7.44 and the HCO3 is 33 it is a Metabolic Alkalosis with Respiratory
Compensation bringing the pH back to WNL but not past midpoint.

pH pCO2 HCO3 Interpretation*

  WNL Respiratory Alkalosis
 WNL  Metabolic Alkalosis
  WNL Respiratory Acidosis
 WNL  Metabolic Acidosis
< 7.4   Compensated Resp. Acidosis
> 7.4   Compensated Resp. Alkalosis
< 7.4   Compensated Meta. Acidosis
> 7.4   Compensated Meta. Alkalosis
*Where compensation is not involved you can look at the arrows:
• Arrows are in same direction = metabolic conditions
• Arrows in opposite direction = respiratory conditions
Problems with readings of pulse oximeters
Clinical Situation Result
Carboxyhemoglobin Falsely High Saturation
Bilirubin Falsely High Saturation
Melanotic Skin Variable, Reduced Signal
Poor Peripheral Perfusion Low Signal, Unreliable Results
Website to use for online analysis of Blood Gas Values:
http://medcalc.com/acidbase.html

Created by P. Keally 10/18/2007