From where we obtain blood?

Arterial blood gas levels are obtained through an

arterial puncture at the:
♪ radial
♪ brachial
♪ femoral artery
♪ through an indwelling arterial
catheter
 Information provided by an ABG
PaCO2
 This is the partial pressure of carbon dioxide
dissolved within the arterial blood. It is used to
assess the effectiveness of ventilation. A high
PaCO2 <45 (respiratory acidosis) indicates
underventilation, a low PaCO2 >35 (respiratory
alkalosis) indicates hyper- or overventilation.
normal range: 35 – 45 mmhg
 PaO2
 This is the partial pressure of oxygen dissolved
within the arterial b;lood and will determine
oxygen binding to hemoglobin (SaO2). It is of
vital importance but not used in determining
patients’ acid base status and normally low
reading indicate hypoxemia.
normal range: 80-100 mmhg
9-3-13.3 kPA
 SaO2
 Oxygen saturation measures how much of
the hemoglobin (Hb) in the red blood
cells is carrying oxygen (O2). Although
similar to Sp02 (measured by the pulse
oximeter), it is more accurate. The
normal levels are 95% and above,
although levels above 90% are often
acceptable in critically ill patients.
 pH
The pH measures hydrogen ions (H+)
in the blood. The pH of blood usually
between 7.35 – 7.45.
A pH lower than 7.35 = Acidosis
 a pH greate than 7.45 = Alkalosis
 HCO3 (Bicarbonate)
 It is a chemical (buffer) that keeps the ph of
blood from becoming too acidic or to basic &
indicates whether a metabolic problem is present
(such as ketoacidosis).
 A low HCO3 indicates metabolic acidosis (<22).
 A high HCO3 indicated metabolic alkalosis (>26).
* HCO3 level can also become abnormal when the kidneys are
working to compensate for a respiratory issue so as to normaliza
the bleed ph.
normal range – 22-26 mEq/L
 Base Excess (BE)
 The base excess is used for the
assessment of metabolic component of
acid – base disorders, and indicates
whether the patient has metabolic
acidosis or metabolic alkalosis.
A negative base excess indicates that the
patient has metabolic acidosis (primary or
secondary to respiratory alkalosis)
A positive base excess indicates that the
patient has metabolic alkalosis (primary or
secondary to respiratory acidosis)

normal range = -2 to +2 mmol/L

 When ABG is ordered?
 blood gas test are ordered when you have symptoms
of an O2/CO2 or pH imbalance, such as difficulty
breathing or shortness of breath and also if you are
known to have a respiratory, metabolic or kidney
disease and those are experiencing respiratory
distress to evaluate oxygenation and acid/base
balance.
 patients who are “on Oxygen” (have supplemental
oxygen) may have their blood gases measured at
intervals to monitor the effectiveness of treatment.
Also be ordered for patients with head or
neck trauma, injuries that may affect
breathing.

Patients undergoing prolonged anesthesia –

particularly for cardiac bypass surgery or
brain surgery – may have their blood gases
monitored during and for a period after the
procedure.
 EXAMPLE 1
PaO2: 52.5 mmHg

pH: 7.29

PaCO2: 68.2 mmHg

HCO3–: 26

Base excess: +1

ANSWER: RESPIRATORY
ACIDOSIS
EXAMPLE 2
PaO2: 105 mmHg

pH: 7.49

PaCO2: 24 mmHg

HCO3–: 22

BE: +2

ANSWER: RESPIRATORY
ALKALOSIS
EXAMPLE 3

pH: 7.31

PaCO2: 35 mmHg

HCO3–: 20

ANSWER: METABOLIC ACIDOSIS