ARTERIAL BLOOD GAS

Kenneth D. Santos, R.N., C.R.N.

Arterial Blood Gas

assess the lungs function and gas exchange

It will measure your lungs ability to move oxygen (O2) into the blood and remove carbon dioxide (CO2) from the blood.

effectiveness of oxygen therapy acid/base balance

Arterial Blood Gas

pH. The pH measures hydrogen ions (H+) in blood. The pH of blood is usually between 7.35 and 7.45. A pH of less than 7.0 is called acid and a pH greater than 7.0 is called basic (alkaline). So blood is slightly basic. Partial pressure of carbon dioxide (PaCO2). This measures how much carbon dioxide is dissolved in the blood and how well carbon dioxide is able to move out of the body. Bicarbonate (HCO3). Bicarbonate is a chemical (buffer) that keeps the pH of blood from becoming too acidic or too basic.

Arterial Blood Gas

Partial pressure of oxygen (PaO2). This measures the pressure of oxygen dissolved in the blood and how well oxygen is able to move from the airspace of the lungs into the blood. Oxygen content (O2CT) and oxygen saturation (O2Sat) values. O2 content measures the amount of oxygen in the blood. Oxygen saturation measures how much of the hemoglobin in the red blood cells is carrying oxygen (O2).

Cases/Diseases that may require ABG

certain respiratory (lung), metabolic, or kidney diseases receiving supplemental oxygen, especially those on ventilators (breathing machines), uncontrolled Diabetes Mellitus, heart failure, sleep apnea, kidney failure, or drug overdose might require ABG testing with lung diseases such as COPD, asthma, cystic fibrosis, pulmonary embolism, or pulmonary fibrosis might have ABG testing during the course of their illness.

Preparation and Puncture Site

There is no special preparation. If you are on oxygen therapy, the oxygen concentration must remain constant for 20 minutes before the test. The blood may be collected from the radial artery in the wrist, the femoral artery in the groin, or the brachial artery in the arm.

Risks

bleeding, clotting, bruising, pain, fainting, hematoma (blood accumulating under the skin), arterial damage (rare), and infection.

Interpretation: Normal Values

Arterial blood pH of 7.35 - 7.45 Partial pressure of carbon dioxide (PaCO2) - 38 - 42 mmHg Bicarbonate - (HCO3) - 22 - 28 mEq/L Partial pressure of oxygen (PaO2) - 75 - 100 mmHg Oxygen saturation (SaO2) - 94 100%

Interpretation

Elevated pH: Alkalemia Low pH: Acidemia Elevated PaCO2: Acidosis Low PaCO2: Alkalosis

Elevated HCO3: Alkalemia Low HCO3: Acidosis

Interpretation
Step 1: Look at the PH first. Draw an arrow if it is a low or high. An arrow indicating low means acidosis. An arrow indicating high means alkalosis. Next, look at the respiratory indicator (PaCO2). Draw an arrow if it is low or high. Step 2: If the arrows are in the opposite direction, the problem is respiratory in nature-either resp.acidosis or resp.alkalosis. Next, look at the metabolic indicator (HCO3). Draw an arrow if it is low or high.

Interpretation
Step 3: If the pH arrow and the metabolic arrow are in the same direction, the problem is of metabolic in nature-either metab. acidosis or metab. alkalosis.

Step 4: Compensation is present if the arrows of PaCO2 and HCO3 are opposite.Partial compensation is present if the arrows of PaCO2 and HCO3 point in the same direction.