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ABG Analysis - NCMB 312 Skills Laboratory

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To assess ventilation and acid-base balance

Radial artery is the common site for


withdrawal of blood specimen
Avoid suctioning prior the procedure
Use 10ml pre-heparenized syringe to draw
blood specimen to prevent clotting of the
specimen
Place the specimen in a container with ice to
prevent hemolysis. If hemolysis occurs,
oxygen and carbon dioxide are released and
cannot be measured accurately.
Allen’s test to assess for adequacy of collateral
circulation of the hand
ABG ANALYSIS
CO2 O2 HCO3 pH

56 81 15 7.12

28 90 32 7.76

35 100 24 7.37

45 95 18 7.28

30 87 45 7.53
LEVEL OF COMPENSATION

PARTIALLY COMPENSATION
– abnormal pH, pCO2, and HCO3

UNCOMPENSATED
– abnormal pH, abnormal pCO2 or HCO3

FULLY COMPENSATED
– normal pH, abnormal pCO2 or HCO3
ABG ANALYSIS

CO2 O2 HCO3 pH

36 91 35 7.52

58 80 22 7.26

43 85 14 7.13

39 95 23 7.38

32 99 45 7.63
LEVEL OF OXYGENATION

MILD HYPOXEMIA – O2 = 60 – 79

MODERATE HYPOXEMIA – O2 = 40 - 69

SEVERE HYPOXEMIA – O2 = 20 – 39

VERY SEVERE HYPOXEMIA – O2 = 0 - 19


ABG ANALYSIS WITH LEVEL OF
COMPENSATION AND OXYGENATION

CO2 O2 HCO3 pH
21 173 24 7.58

35 68 12 7.23

63 88 34 7.13

57 195 29 7.35

42 209 45 7.76
RESPIRATORY ACIDOSIS

Increase CO2, Decrease Ph


Carbonic acid excess Above 45, below 7.35
Hypercapnia Hypoventilation
CO2 Retained K excess
COPD O2 therapy
Overdose of narcotics and sedatives
Depressed respiratory center
RESPIRATORY ALKALOSIS

Decrease CO2, Increase Ph


Carbonic acid deficit Below 35, above 7.45
Hypocapnia Hyperventilation
CO2 Eliminated K deficit
Pneumonia Brown bag
Aspirin poisoning Anxiety
METABOLIC ACIDOSIS
Decrease bicarbonate, Decrease Ph
Bicarbonate deficit Below 22, below 7.35
Diarrhea Loss of alkaline in GIT
NPO K excess
Kussmaul breathing Renal failure
DM/Diabetic ketoacidosis
Circulatory shock Celiac Disease
Excessive infusion of chloride
Anaerobic metabolism of glucose
Sodium Bicarbonate
METABOLIC ALKALOSIS
Increase bicarbonate, Increase Ph
Bicarbonate excess Above 26, above 7.45
Vomiting Loss of acid in GIT
Gastric lavage Intestinal fistula
K deficit Cushing syndrome
Depressed breathing Hyperaldosteronism
Excessive adrenal corticoid hormone
Increase secretion of HCO3 in kidneys (Diuretics)
Excessive ingestion of baking soda

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