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ABG www.medicalppt.blogspot.com - Arterial Blood Gas...

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Arterial Blood Gas Analysis …..1 Dr Satish Deopujari Pediatrician Hon. Prof. ( Paed.) JNMC Chairperson Intensive care chapter Indian academy of pediatrics [email protected] Published by www.medicalppt.blogspot.com No click
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The Goal : To provide Bedside approach to ABG analysis No click
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H ION CONC. N.MOLS / L. pH 20 7.70 30 7.52 40 7.40 50 7.30 60 7.22 H ION OH ION 0 14 pH stand for "power of hydrogen" H + = 80 - last two digits of pH Don’t click wait …. .till Last message ……. . “H = 80-last two digits of pH”
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Bicarbonate: Henderson - Hasselbach equation: pH = pK + Log HCO3 Dissolved CO2 No click
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Standard Bicarbonate: Plasma HCO 3 after equilibration to a PaCO 2 of 40 mm Hg : Reflects non-respiratory acid base change : No quantification of the extent of the buffer base abnormality Base Excess: base to normalise HCO 3 (to 24) with PaCO 2 at 40 mm Hg (Sigaard-Andersen) : Reflects metabolic part of acid base : No info. over that derived from pH, pCO 2 and HCO 3 : Misinterpreted in chronic or mixed disorders No click
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Oxygenation Indices: O 2 Content of blood: Hb. x O 2  Sat  + Dissolved O 2 (Don’t forget hemoglobin) Oxygen Saturation: ( Derived from oxygen dis. curve                not a measured value ) Alveolar / arterial gradient: ( Useful … to classify r. failure ) No click
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0 10 20 30 40 50 60 70 80 90 100 PaO 2 20 40 60 80 100 Rt. Shift Normal arterio/venous difference Shift of the curve ……changes saturation for a given PaO 2 Normal No click Oxygen delivered to tissues with normally placed curve Delivered oxygen with Rt. Shift curve
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Alveolar-arterial Difference Inspired O 2 = 21 % p i O 2 = (760-45) x . 21 = 150 mmHg O 2 CO 2 p alv O 2 = p i O 2 pCO 2 / RQ = 150 – 40 / 0.8 = 150 – 50 = 100 mm Hg PaO 2 = 90 mmHg p alv O 2 p art O 2 = 10 mmHg One click and wait
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Alveolar- arterial Difference O 2 CO 2 Oxygenation Failure WIDE GAP p i O 2 = 150 pCO 2 = 40 p alv O 2 = 150 – 40/.8 =150-50 =100 PaO 2 = 45 = 100 - 45 = 55 Ventilation Failure NORMAL GAP p i O 2 = 150 pCO 2 = 80 p alv O 2 = 150-80/.8 =150-100 = 50 PaO 2 = 45 = 50 - 45 = 5 PAO 2 (partial pres. of O 2 . in the alveolus.) = 150 - ( PaCO 2 / .8 ) 760 – 45 = 715 : 21 % of 715 = 150 No click
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20 × 5 = 100 Expected PaO 2 = FiO 2 × 5 = PaO 2 Normal situation No click
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The Blood Gas Report: normals … pH 7.40 + 0.05 PaCO 2 40 + 5 mm Hg PaO 2 80 - 100 mm Hg HCO 3 24 + 4 mmol/L O2 Sat >95 Always mention and s ee FIO2 The essentials HCO3 No click
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5 The Steps    for Successful Blood Gas Analysis No click
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Step 2 Who is res pons ible for this change in pH ( culprit )? CO 2 will change pH in oppos ite direction Bicarb will change pH in s ame direction
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This note was uploaded on 12/27/2011 for the course STEP 1 taught by Professor Dr.aslam during the Fall '11 term at Montgomery College.

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ABG www.medicalppt.blogspot.com - Arterial Blood Gas...

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