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<div></div>Jshupehttps://wikem.org/w/index.php?title=Arterial_blood_gas_analysis&diff=107332Arterial blood gas analysis2016-10-22T17:32:20Z<p>Jshupe: typo</p>
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<div>==Basics==<br />
==='''pH'''===<br />
*Measurement of acidity or alkalinity of solution . The normal range is 7.35 to 7.45<br />
*pH > 7.45 = alkalosis<br />
*pH< 7.35 = acidosis<br />
==='''PaO<sub>2</sub>'''===<br />
The partial pressure of oxygen that is dissolved in arterial blood. The normal range is 80 to 100 mm Hg.<br />
'''SaO<sub>2</sub>'''<br />
The arterial oxygen saturation. The normal range is 95% to 100%.<br />
==='''pCO<sub>2</sub>'''===<br />
*The amount of carbon dioxide dissolved in arterial blood. The normal range is 35 to 45 mm Hg.<br />
*pCO<sub>2</sub> >45 = acidosis<br />
*pCO<sub>2</sub> <35 = alkalosis<br />
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==='''HCO<sub>3</sub>'''===<br />
The calculated value of the amount of bicarbonate in the bloodstream. The normal range is 22 to 26 mEq/liter<br />
HCO3 > 26 = alkalosis<br />
HCO3 < 22 = acidosis<br />
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==='''B.E.'''===<br />
*The base excess indicates the amount of excess or insufficient level of bicarbonate in the system.<br />
*The normal range is -2 to +2 mEq/liter.<br />
*A negative base excess indicates a base deficit in the blood.<br />
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==ABG in Hypothermia==<br />
*Blood gas analyzers typically warm blood to 37°C before making calculations however physicians should simply interpret the values as given by the lab<br />
*At any temperature, a pH of 7.4 and a PCO2 of 40 mm Hg represent normal acid-base balance<br />
The best (simplest) approach is to use uncorrected ABG values compared with the normal values at 37°C<ref>Burnett RW, Noonan DC. Calculations and correction factors used in determination of blood pH and blood gases. Clin Chem. 1974 Dec;20(12):1499-506. Review. </ref><br />
===TEMPERATURE CORRECTION OF PO2 and PCO2===<br />
Oxygen and carbon dioxide increase in solubility as water temperature lowers, so warmed ABGs from hypothermic patients with show a higher PaO2, higher PaCO2 and a lower pH than what is actually present in the patient’s blood although the clinical implications of this change is not significant.<ref>Ashwood ER, Kost G, Kenny M. Temperature correction of blood-gas and pH measurements. Clin Chem. 1983 Nov;29(11):1877-85. Review. PubMed PMID: 6354511.</ref><br />
*PO2 is 5 mmHg lower for each degree below 37C° <br />
*PCO2 is 2mmHg lower for each degree below 37C°<br />
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==ABG after Cardiac Arrest==<br />
pH of blood dependent on:<br />
*cause of arrest<br />
*duration of arrest when ABG is taken<br />
*the quality of the CPR and ventilation the patient is receiving<br />
*temperature of the patient when ABG taken<br />
*drugs administered during arrest (ie. Adrenaline and NaHCO3)<br />
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'''Elevated pCO<sub>2</sub>'''<br />
*often due to inadequate ventilation during resuscitation<br />
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'''Low PaO2'''<br />
*insufficient oxygenation during resuscitation<br />
*aspiration<br />
*pulmonary edema<br />
*PE<br />
*primary respiratory pathology<br />
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'''[[Hyperkalemia]] Causes'''<br />
*cell death<br />
*loss of cell membrane integrity and acidosis<br />
*other sources such as missed dialysis<br />
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==References==<br />
<references/><br />
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[[Category:Critical Care]]<br />
[[Category:Pulmonary]]</div>Jshupehttps://wikem.org/w/index.php?title=User:Jshupe&diff=60047User:Jshupe2016-03-25T04:46:20Z<p>Jshupe: </p>
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<div>Jason Shupe, DO.<br />
PGY3 FM MMCR</div>Jshupe