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ARTERIAL
BLOOD GAS
~ Digvijay Surendra Raut. BAMS 2nd YEAR
pH 7.35 - 7.45
CO2 35 - 45
pO2 80 - 100
HCO3 22 - 26
O2Sat. 95 - 100%
ACID - BASE BALANCE
1. The primary aim of keeping this delicate balance is to
preserve the Homeostasis i.e. the highly complex
interactions that maintain all body systems to functioning
within a normal range.
2. Any extreme change in this balance ( PH < 6.8 or > 7.8)
may result in disastrous changes e.g. denaturation of
proteins & shut down of all enzymatic and metabolic
processes. Such disturbed environment would be
incompatible with life.
Types of Acid - Base Imbalance
1.Respiratory Acidosis
2.Respiratory Alkalosis
3.Metabolic Acidosis
4.Metabolic Alkalosis
(I) Respiratory Acidosis
1. It is defined as a pH less than 7.35 with a PaCO2 greater
than 45 mmHg.
2. Acidosis is the accumulation of co₂ which combines with
water in the body to produce carbonic acid, thus lowering
the pH of the blood.
ABG pH PaCO2 HCO3
Respiratory Normal
Acidosis
Causes of Respiratory Acidosis
•Hypoventilation
•Neuromuscular Weakness (Gullian
Barre Syndrome)
•Obesity
•Asthma
Clinical Manifestation
• Muscular Weakness
• Tachypnea
• Blurred Vision
• Confusion
• Memory loss
• Restlessness
(II) Respiratory Alkalosis
1. It is defined as a pH greater than 7.45 with a PaCO2
lesser than 35 mmHg.
2. Alkalosis is due to excessive wash of co₂ 2
(hyperventilation), thus increasing the pH of the
blood.
ABG pH PaCO2 HCO3
Respiratory Normal
Alkalosis
Causes Respiratory Alkalosis
• Hyperventilation
• Fluid loss
• Liver disease
• Alteration in gas exchange
• Pneumonia
• Stress
Clinical Manifestation
•Palpitation
•Tetany (muscle spasm)
•Convulsion
•Paralysis
•Chest pain
(III) Metabolic Acidosis
• It is defined as a pH less than 7.35 with a HCO3 less than 22 mEq/L.
• Toxic Causes: Any disorder that will lead to tissue hypoperfusion
whatever the cause will lead eventually to increase in lactic acid
production resulting in Metabolic Acidosis.
• Alcohol
• Cancer
• Diarrhea
• Liver failure
• Poisoning by aspirin and methanol
• Sever dehydration
• Seizure
Clinical Manifestation
• Diarrhea
• Chest pain
• Rapid breathing
• Hypotension
• Arrhythmia
• Joint pain
(IV) Metabolic Alkalosis
• It is defined as a pH greater than 7.45 with HCO3 greater
than 28 mEq/L
• Causes
• It is due to excessive acid loss (repeated vomiting and
nasogastric suction) OR bicarbonate retention e.g. overuse
of sodium bicarbonate.
ABG pH PaCO2 HCO3
Metabolic Normal
Alkalosis
Causes Metabolic Alkalosis
• Alcohol abuse
• Hyperaldesteron
• Diarrhea and vomiting
• High fever
• Diuretic therapy
• Cystic fibrosis
Clinical Manifestation
•Decrease blood pressure
•Rapid heart rate
•Irritability
•Cyanosis
•Coma
Procedure of Arterial Blood Gas analysis
Equipment Required
A clean tray containing:
• Gloves
• Antiseptic solution
• Local anesthesia
• 0.5 ml sodium heparin (1:1000)
• 2 3 ml syringe with 20, 23 and 25 gauze needle.
• Paper bag
Preparation of client
■ To record the temperature of the client.
■ Record inspired oxygen concentration of the
client.
■ Heparnised the syringe to prevent blood
clotting.
■ To reduce anxiety of the client.
■ Allen's test
Allen's Test
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