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Arterial Blood Gases
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Critical Care

Reminders and helpful tips for Critical Care Staff

ARTERIAL BLOOD GASES: NORMAL VALUES
 
pH                                  7.35 to 7.45
pO2*                              80 to 100 mmHg
pCO2                              35 to 45 mmHg
HCO3                              21 to 25 mEq/L
O2 sat                            95% to 99%
Base Excess                 -2 to +2
 
*In a patient >60 years of age, pO2 is equal to 80 mmHg - 1 mmHg for every year over 60. Expected pO2 can be determined by multiplying the FIO2 by 5.
 
INTREPRETING ABGs
 
1. Check pH     >7.45 = alkalosis       <7.35 = acidosis
2. Check pCO2  elevated = CO2 retention (hypoventilation)
                       respiratory acidosis or compensation for metabolic
                       alkalosis.
                             decreased = CO2 being blown off, (hyperventilation)
                       respiratory alkalosis or compensation for metabolic
                       acidosis.
                             nil   = no respiratory component imbalance
3. Check HCO3  elevated  = nonvolatile acid is lost, HCO3 gained 
                       (metabolic alkalosis or compensation for respiratory
                       acidosis)
                             decreased = nonvolatile acid is added, HCO3 is lost
                        (metabolic acidosis or compensation for respiratory
                        alkalosis.
4. Determine Imbalance.
5. Determine if compensation exists.
                          
               IF                                                               THEN
 
pH up and pCO2 down
              or                                      RESPIRATORY DISORDER
pH down and pCO@ up
 
pH up and HCO3 up
              or                                      METABOLIC DISORDER
pH down and HCO3 down
 
pCO2 up and HCO3 up                          COMPENSATION OCCURING
              or
pCO2 down and HCO3 down
 
pCO2 up and HCO3 down
              or                                       MIXED IMBALANCE    
pCO@ down and HCO3 up
 

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