Arterial Blood Gas analysis typically

measures:
pH (Acidity)
pCO2 (Partial Pressure of Carbon
Dioxide)
pO2 (Partial Pressure of Oxygen)
CO2 (Carbon Dioxide Content)
Base Excess (The loss of Buffer Base
to neutralize acid)
And may include:

Normal Adult Arterial Values*

pH

7.35-7.45

pCO2

35-45 torr

pO2

>79 torr

CO2

23-30
mmol/L

Base
Excess/Deficit
SO2

pH is a measurement of the acidity of the

blood, reflecting the number of hydrogen
ions present.
Lower numbers mean more acidity; higher
number mean more alkalinity.

Normal Adult Venous Values*

pH

7.31-7.41

pCO2

41-51 torr

pO2

30-40 torr

CO2

23-30
mmol/L

Base
Excess/Deficit
SO2

pH is Elevated (more alkaline, higher pH)

with:

>94%

Oxygen Saturation

These measurements are often used to

evaluate oxygenation of the tissues and
pulmonary function.

3 mEq/L

Hyperventilation
Anxiety, pain
Anemia
Shock
Some degrees of Pulmonary disease
Some degrees of Congestive heart
failure
Myocardial infarction
Hypokalemia (decreased potassium)
Gastric suctioning or vomiting
Antacid administration
Aspirin intoxication

pH is Decreased (more acid, lower pH)

with:

3 mEq/L
75%

Blood Gas Abbreviations

BE

Base Excess (positive

number) or Base Deficit
(negative number)

HCO3

Bicarbonate

H2CO3

Carbonic Acid

PO2

Partial Pressure of
Oxygen

PaO2

Partial Pressure of
Oxygen in Arterial
Blood

PvO2

Partial Pressure of
Oxygen in Venous Blood

PCO2

Partial Pressure of

Strenuous physical exercise

Obesity
Starvation
Diarrhea
Ventilatory failure
More severe degrees of Pulmonary
Disease
More severe degrees of Congestive
Heart Failure
Pulmonary edema
Cardiac arrest
Renal failure
Lactic acidosis
Ketoacidosis in diabetes

pCO2 (Partial Pressure of Carbon

Dioxide) reflects the the amount of carbon
dioxide gas dissolved in the blood.
Indirectly, the pCO2 reflects the exchange of
this gas through the lungs to the outside air.
Two factors each have a significant impact
on the pCO2. The first is how rapidly and
deeply the individual is breathing:

Someone who is hyperventilating

will "blow off" more CO2, leading to
lower pCO2 levels
Someone who is holding their breath
will retain CO2, leading to increased
pCO2 levels

The second is the lungs capacity for freely

exchanging CO2 across the alveolar
membrane:

With pulmonary edema, there is an

extra layer of fluid in the alveoli that
interferes with the lungs' ability to
get rid of CO2. This leads to a rise in
pCO2.
With an acute asthmatic attack, even
though the alveoli are functioning
normally, there may be enough upper

Carbon Dioxide
PaCO2

Partial Pressure of
Carbon Dioxide in
Arterial Blood

PvCO2

Partial Pressure of
Carbon Dioxide in
Venous Blood

SO2

Oxygen Saturation

SaO2

Oxygen Saturation in
Arterial Blood

SvO2

Oxygen Saturation in
Venous Blood

TCO2

Total Carbon Dioxide

Content

and middle airway obstruction to

block alveolar ventilation, leading to
CO2 retention.
Increased pCO2 is caused by:

Pulmonary edema
Obstructive lung disease

Decreased pCO2 is caused by:

Hyperventilation
Hypoxia
Anxiety
Pregnancy
Pulmonary Embolism (This leads to
hyperventilation, a more important
consideration than the
embolized/infarcted areas of the lung
that do not function properly. In
cases of massive pulmonary
embolism, the infarcted or nonfunctioning areas of the lung assume
greater significance and the pCO2
may increase.)

PO2 (Partial Pressure of Oxygen) reflects

the amount of oxygen gas dissolved in the
blood. It primarily measures the
effectiveness of the lungs in pulling oxygen
into the blood stream from the atmosphere.
Elevated pO2 levels are associated with:

Increased oxygen levels in the

inhaled air
Polycythemia

Decreased PO2 levels are associated with:

Decreased oxygen levels in the

inhaled air
Anemia
Heart decompensation

Chronic obstructive pulmonary

disease
Restrictive pulmonary disease
Hypoventilation

CO2 Content is a measurement of all the

CO2 in the blood.
Most of this is in the form of bicarbonate
(HCO3), controlled by the kidney. A small
amount (5%) of the CO2 is dissolved in the
blood, and in the form of soluble carbonic
acid (H2CO3).
For this reason, changes in CO2 content
generally reflect such metabolic issues as
renal function and unusual losses (diarrhea).
Respiratory disease can ultimately effect
CO2 content, but only slightly and only if
prolonged.
Elevated CO2 levels are seen in:

Severe vomiting
Use of mercurial diuretics
COPD
Aldosteronism

Decreased CO2 levels are seen in:

Renal failure or dysfunction

Severe diarrhea
Starvation
Diabetic Acidosis
Chlorthiazide diuretic use

Base Excess or Base Deficit

Whenever there is an accumulation of
metabolically-produced acids, the body
attempts to neutralize those acids to maintain

a constant acid-base balance.

This neutralizing is achieved by using up
various "buffering" compounds in the blood
stream, to bind the acids, disallowing them
from contributing to more acidity.
About half of these buffering compounds
come from HCO3, and the other half from
plasma and red blood cell proteins and
phosphates.
The words "base deficit" and "base excess"
are equivalent and are generally used
interchangeably. The only difference is that
base deficit is expressed as a positive
number and base excess is expressed as a
negative number.
A "Base Deficit" of 10 means that 10
mEqu/L of buffer has been used up to
neutralize metabolic acids (like lactic acid).
Another way to say the same thing would be
the "Base Excess is minus 10."
More Negative Values of Base Excess may
Indicate:

Lactic Acidosis
Ketoacidosis

Ingestion of acids

Cardiopulmonary collapse

Shock

More Positive Values of Base Excess may

Indicate:

Loss of buffer base

Hemorrhage

Diarrhea

Ingestion of alkali

Oxygen Saturation (SO2) measures the

percent of hemoglobin which is fully
combined with oxygen.
While this measurement can be obtained
from an arterial or venous blood sample, it's
major attractive feature is that it can be
obtained non-invasively and continuously
through the use of a "pulseoximeter."
Normally, oxygen saturation on room air is
in excess of 95%. With deep or rapid
breathing, this can be increased to 98-99%.
While breathing oxygen-enriched air (40% 100%), the oxygen saturation can be pushed
to 100%.
Oxygen Saturation will fall if:

Inspired oxygen levels are

diminished, such as at increased
altitudes.
Upper or middle airway obstruction
exists (such as during an acute
asthmatic attack)
Significant alveolar lung disease
exists, interfering with the free flow
of oxygen across the alveolar
membrane.

Oxygen Saturation will rise if:

Deep or rapid breathing occurs

Inspired oxygen levels are increased,

such as breathing from a 100%
oxygen source