BASICS IN ABG ANALYSIS AND
INTERPRETATION
DR.S.RAMACHANDRAN MPT, (Ph.D)
PROFESSOR
FACULTY OF PHYSIOTHERAPY
ACS MEDICAL COLLEGE AND HOSPITAL
CHENNAI – 600 077.
SYNOPSIS
1. Definition
2. Indication
3. ABG component
4. Normal values
5. Sites for obtaining ABG
6. Complication
7. A look at acids and bases
8. Acid base disorders
9. Respiratory acidosis
10. Case - A
11. Case –B
12. Case - C
13. Case – D
14. Reference
DEFINITION
It is a diagnostic procedure in which blood is obtained
from an artery directly by an arterial puncture or accessed
by a way of indwelling arterial catheter.
I N D I CA TI ON
To obtain information about patient ventilation (PCO2) , oxygenation (PO2)
and acid base balance
Monitor gas exchange and acid base abnormalities for patient on mechanical
ventilator or not
To evaluate response to clinical intervention and diagnostic evaluation
( oxygen therapy )
An ABG test may be most useful when a person's breathing rate is increased or
decreased or when the person has very high blood sugar levels, a severe infection,
or heart failure.
ABG COMPONENT
PH:
Measures hydrogen ion concentration in the blood, it shows blood’s acidity or
alkalinity.
PCO2 :
It is the partial pressure of CO2 that is carried by the blood for excretion by the
lungs, known as respiratory parameter.
PO2:
It is the partial pressure of O2 that is dissolved in the blood , it reflects the body
ability to pick up oxygen from the lungs.
HCO3 :
Known as the metabolic parameter, it reflects the kidney’s ability to retain and
excrete bicarbonate. Helps pH of blood from becoming too acidic or too basic .
NORMAL VALUES
PH = 7.35 – 7.45
Pco2= 35-45mmHg
Po2 = 80-100mHg
HCO3=22-26 meq/L
SITES FOR OBTAINING ABG
Radial artery ( most common )
Brachial artery
Femoral artery
Radial is the most preferable siteused because:
It is easy to access
It is not a deep artery which facilitate palpation, stabilization and puncturing
The artery has a collateral blood circulation
SITES FOR OBTAINING ABG
COMPLICATION
Arteriospasm
Hematoma
Hemorrhage
Distal ischemia
Infection
Numbness
A LOOK AT ACIDS AND BASES
The body constantly works to maintain a balance
(homeostasis) between acids and bases. Without that balance, cells can’t
function properly. As cells use nutrient to produce the energy, two by-
products are formed H+ & CO2. acid-base balance depends on the
regulation of the free hydrogen ions
Even slight imbalance can affect metabolism and essential body
functions. Several conditions as infection or trauma and medications can
affect acid-base balance .
ACID BASE DISORDERS
RESPIRATORY ACIDOSIS
Respiratory acidosis occurs when too much CO2 builds up in the body.
Normally, the lungs remove CO2 while exhaling.
This may happen due to:
•Chronic airway conditions, like asthma
•Injury to the chest
•Obesity, which can make breathing difficult
•Sedative misuse
•Muscle weakness in the chest
•Problems with the nervous system
•Deformed chest structure
RESPIRATORY ALKALOSIS
Respiratory alkalosis occurs when there isn’t enough carbon dioxide in the
bloodstream.
It’s often caused by:
•hyperventilation, which commonly occurs with anxiety
•high fever
•lack of oxygen
•salicylate poisoning
•liver disease
•lung disease
METABOLIC ALKALOSIS
Metabolic alkalosis develops when body loses too much acid or gains too much base.
This can be attributed to:
•Excess vomiting, which causes electrolyte loss
•Overuse of diuretics
•A large loss of potassium or sodium in a short amount of time
•Antacids
•Accidental ingestion of bicarbonate, which can be found in baking soda
•Laxatives
•Alcohol abuse.
Metabolic acidosis :starts in the kidneys instead of the lungs. It occurs when
they can’t eliminate enough acid or when they get rid of too much base.
Diabetic acidosis occurs in people with diabetes that’s poorly controlled. When
body lacks
enough insulin, ketone build up in the body and acidify blood.
•Hyperchloremic acidosis results from a loss of sodium bicarbonate. This base
helps to keep the blood neutral.
Both diarrhea and vomiting can cause this type of acidosis.
•Lactic acidosis occurs when there’s too much lactic acid in body. Causes can
include chronic alcohol
use, cancer, seizures, liver failure, prolonged lack of oxygen, and low blood
sugar.
•Renal tubular acidosis occurs when the kidneys are unable to excrete acids into
the urine.
CASE- A CASE -B
PH - 7.10 PH – 7.65
Paco2- 40 mmHg Paco2- 40 mmHg
Hco3- 16 meq/L Hco3- 32 meq/L
DIAGNOSIS…….? DIAGNOSIS……?
CASE - C CASE -D
PH – 7.11 PH – 7.58
Paco2- 50 mmHg Paco2- 25 mmHg
Hco3- 24 meq/L Hco3- 23 meq/L
DIAGNOSIS……? DIAGNOSIS……?
REFERENCE
Cash’s textbook of chest, vascular disorders for physiotherpists - Patricia
A. Downie
Textbook of physiotherapy for cardio respiratory ,cardiac surgery and
thoracic surgery condition -G B Madhuri.
Textbook of Clinical medicine - Clark and Praveenkumar
