Scribd Logo
Upload

Welcome to Scribd!

  • 23 views

    ABG - Simplified: Dr.S.Arun Cheguevara

    Uploaded by

    Smilewith Rakshi
    This document provides guidance on interpreting arterial blood gas (ABG) results. It begins by listing the normal ranges for pH, PaCO2, PaO2, HCO3, and base excess. It then outlines 9 steps for ABG interpretation: 1) check PaO2, 2) check pH, 3) check PaCO2, 4) check HCO3, 5) check anion gap, 6) check for compensation, 7) check lactates, and 8) check electrolytes and Hb. Key causes and types of respiratory and metabolic acidosis and alkalosis are described. The document emphasizes using a systematic approach and considering compensation when interpreting ABG results.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd

    ABG - Simplified: Dr.S.Arun Cheguevara

    Uploaded by

    Smilewith Rakshi
    23 views29 pages
    This document provides guidance on interpreting arterial blood gas (ABG) results. It begins by listing the normal ranges for pH, PaCO2, PaO2, HCO3, and base excess. It then outlines 9 steps for ABG interpretation: 1) check PaO2, 2) check pH, 3) check PaCO2, 4) check HCO3, 5) check anion gap, 6) check for compensation, 7) check lactates, and 8) check electrolytes and Hb. Key causes and types of respiratory and metabolic acidosis and alkalosis are described. The document emphasizes using a systematic approach and considering compensation when interpreting ABG results.

    Original Title

    ABG

    Copyright

    © © All Rights Reserved

    Available Formats

    PPTX, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    This document provides guidance on interpreting arterial blood gas (ABG) results. It begins by listing the normal ranges for pH, PaCO2, PaO2, HCO3, and base excess. It then outlines 9 steps for ABG interpretation: 1) check PaO2, 2) check pH, 3) check PaCO2, 4) check HCO3, 5) check anion gap, 6) check for compensation, 7) check lactates, and 8) check electrolytes and Hb. Key causes and types of respiratory and metabolic acidosis and alkalosis are described. The document emphasizes using a systematic approach and considering compensation when interpreting ABG results.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    23 views29 pages

    ABG - Simplified: Dr.S.Arun Cheguevara

    Uploaded by

    Smilewith Rakshi
    This document provides guidance on interpreting arterial blood gas (ABG) results. It begins by listing the normal ranges for pH, PaCO2, PaO2, HCO3, and base excess. It then outlines 9 steps for ABG interpretation: 1) check PaO2, 2) check pH, 3) check PaCO2, 4) check HCO3, 5) check anion gap, 6) check for compensation, 7) check lactates, and 8) check electrolytes and Hb. Key causes and types of respiratory and metabolic acidosis and alkalosis are described. The document emphasizes using a systematic approach and considering compensation when interpreting ABG results.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    You are on page 1of 29

    ABG -simplified

    Dr.S.Arun cheguevara
    ● ? Need for Blood gases
    ● ABG or VBG ?
    ● Contraindications
    ● Pre-test
    ● Site
    ● Positioning
    ● Procedure
    ● Pt comfort
    ● Interpretation
    ● Frequency ?
    NORMAL RANGE
    ● pH: 7.35 – 7.45
    ● PaCO2: 4.7 – 6.0 kPa or 35.2 – 45 mmHg
    ● PaO2: 11 – 13 kPa or 82.5 – 97.5 mmHg
    ● HCO3–: 22 – 26 mEq/L
    ● Base excess (BE): -2 to +2 mmol/L

    kPa to mmHg = kPa *7.5


    STEP 1
    ● CHECK Pa02
    ● Hypoxic or not ?
    STEP 2
    ● Check pH
    ● Acidemia or alkalemia ?
    STEP 3
    ● Check Paco2
    Causes of respiratory acidosis :

    ● Respiratory depression (e.g. opiates)


    ● Guillain-Barre: paralysis leads to an inability to adequately ventilate
    ● Asthma
    ● Chronic obstructive pulmonary disease (COPD)
    ● Iatrogenic (incorrect mechanical ventilation settings)
    Causes of respiratory alkalosis :

    ● Anxiety (i.e. panic attack)


    ● Pain: causing an increased respiratory rate.
    ● Hypoxia: resulting in increased alveolar ventilation in an attempt to
    compensate.
    ● Pulmonary embolism
    ● Pneumothorax
    ● Iatrogenic (e.g. excessive mechanical ventilation)
    RESPIRATORY FAILURE
    ● Type 1 (ventilation/perfusion (V/Q) mismatch)

    Pao2 <60mmHg

    ● Type 2 (alveolar hypoventilation)

    Pao2 <60mmHg

    PaCO2 >45mmHg
    STEP 4
    ● Check HCO3
    Causes of metabolic alkalosis :

    ● Gastrointestinal loss of H+ ions (e.g. vomiting, diarrhoea)


    ● Renal loss of H+ ions (e.g. loop and thiazide diuretics, heart failure, nephrotic
    syndrome, cirrhosis, Conn’s syndrome)
    ● Iatrogenic (e.g. addition of excess alkali such as milk-alkali syndrome)
    Metabolic acidosis :

    ● High anion gap metabolic acidosis (HAGMA)


    ● Normal anion gap metabolic acidosis (NAGMA)
    STEP 5
    ● CHECK ANION GAP
    ● Anion gap formula: (Na+K) – (Cl + HCO3)
    High anion gap metabolic acidosis (HAGMA)
    normal anion gap metabolic acidosis (NAGMA)
    STEP 6 - COMPENSATION
    STEP 6
    ● Check for compensation
    ● Compensated / uncompensated / mixed picture
    ● Respiratory compensation for a metabolic disorder can occur quickly by
    either increasing or decreasing alveolar ventilation to blow off more CO2 (↑
    pH) or retain more CO2 (↓ pH)

    ● Metabolic compensation for a respiratory disorder, however, takes at least


    a few days to occur as it requires the kidneys to either reduce HCO3–
    production (to decrease pH) or increase HCO3– production (to increase pH)
    Uncompensated acid base disorders
    Compensating acid base disorders
    STEP 7
    ● Check lactates

    ● Type of lactic acidosis


    STEP 8
    ● Check electrolytes - K , Na ,ca
    ● Hb
    STEP 9
    BASE EXCESS :

    ● > +2mmol/L : primary metabolic alkalosis or a compensated respiratory


    acidosis
    ● < -2mmol/L : primary metabolic acidosis or a compensated respiratory
    alkalosis
    THANK YOU

    You might also like