Blood Gas Analyzer

Noor Ullah
[email protected]

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Arterial Blood Gases

• Arterial Blood Gas (ABG) Kit

• Prepackaged and contains all
necessary equipment
• 3 – 5 cc Pre-heparinized
syringes
• 22g x 2 needle
• Alcohol swap
• Gauze pad
• Biohazard bag
• Misc. items

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 ABG Specimen Collection/Handling

• Site Selection
• Radial Artery - 45 insertion angle
• Brachial Artery - 60 - 90 insertion
angle
• Femoral Artery - 90 insertion angle
• Dorsalis Pedis Artery
• Site must be adequately compressed
until clotted
• Approximately 5 minutes
• Patients receiving anticoagulation
therapy take longer

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ABG Specimen Collection/Handling
• Handling
• Blood gas specimen should be collected anaerobically
• Expel air bubbles immediately
In Vivo Values Air Contamination
pH 7.40 7.45
PCO240 30
PO2 95 110
• Blood gas specimen must be adequately anticoagulated
• Sodium heparin
• Lithium heparin (electrolytes)
• Sample volume should be 1 – 2 ml
• Each laboratory has its own protocol

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ABG Specimen Collection/Handling
• Handling
• Sample should be analyzed as soon as possible
• If iced sample can be stored
• Glass syringe: 1-2 hour
• Plastic syringe: 15- 20 minutes
• pH  due to lactic acidosis generated by glycolysis in R.B.Cs.
• Remember: Blood is living tissue that continues to consume O2 and produce CO2
• Transport specimen to laboratory in a biohazard container
• Analyze specimen on an instrument that has been recently calibrated
• Temperature correct specimen in analyzer
• Increase in patient temp: PO2, PCO2, pH
• Decrease in patient temp: PO2, PCO2, pH

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ABG Specimen Collection/Handling
• AIR BUBBLES
• PO2 150 mmHg & PCO2 0 mm Hg in air bubble
• Mixing with sample, lead to  PO2 &  PCO2
• To avoid air bubble, sample drawn very slowly and preferably in glass syringe
• Min friction of barrel with syringe wall.
• Usually not need to ‘pull back’ barrel – so less chance of air bubbles entering
syringe
• Small air bubbles adhere to sides of plastic syringes – difficult to expel
• EXCESSIVE HEPARIN

• Dilutional effect on results  HCO3- & PCO2

• Only .05 ml heperin required for 1 ml blood.

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 ABGs- Definition

• Blood gas analysis, also called arterial blood gas (ABG) analysis, is a test which
measures the amounts of oxygen and carbon dioxide in the blood, as well as
the (pH) of the blood.

• Importance:

• ABG analysis evaluates how effectively the lungs are delivering oxygen to the
blood and how efficiently they are eliminating carbon dioxide from it.

• The test also indicates how well the lungs and kidneys are interacting to
maintain normal blood pH (acid-base balance).
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 Parameters of ABGs
• pH: Measurement of acidity or alkalinity, based on the hydrogen (H+)
• 7.35 – 7.45
• PO2: The partial pressure of oxygen that is dissolved in arterial blood.
• 80-100 mm Hg.
• PCO2: The amount of carbon dioxide dissolved in arterial blood.
• 35– 45 mmHg
• HCO3: The calculated value of the amount of bicarbonate in the blood.
• 22 – 26 mmol/L
• SO2:The arterial oxygen saturation.
• >95%
• pH,PO2 ,PCO2 , Lactate and electrolytes are measured Variables
• HCO3 (Measured or calculated)

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Parameters of ABGs
• Buffer Base:
• It is total quantity of buffers in blood including both volatile(HCO3) and
nonvolatile (as Hgb,albumin,PO4)
• Base Excess/Base Deficit:
• Measures total body bases- Hb, Cl, P04
• Amount of strong acid or base needed to restore plasma pH to 7.40 at a PCO2 of
40 mm Hg, at 37⁰C.
• Calculated from pH, PCO2 and HCT
• Negative BE also referred to as Base Deficit
• True reflection of non respiratory (metabolic) acid base status
• Normal value: -2 to +2mEq/L

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ABGs
• Equipment
• Electronic circuitry
• Takes electrical current changes produced in the electrodes and provides a visual
display
• Electrodes measure
• pH, PCO2, PO2
• All other blood gas values are calculated

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Principle of operation
• PO2 Electrode
• The PO2 electrode consists of two terminals: The cathode, which usually made of
platinum, and the anode, which usually made of silver– sliver chloride.
• Battery supplies the platinum cathode with voltage of 700 mV.
• This voltage attracts oxygen molecules to the cathode surface, where they react
with water.
• This reaction consumes four electrons for every oxygen molecule reacts with
water and produces four (OH-).
• The consumed four electrons, in turn, are replaced rapidly in the electrolyte
solution as silver and chloride react at the anode.

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 The cathode, which usually made of platinum (negatively
charged) and (2) the anode, which usually made of silver– sliver
chloride (positively charged).

Source : Akay, M., WILEY ENCYCLOPEDIA OF BIOMEDICAL

ENGINEERING. 2006, Washington: simultaneously in Canada.

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 The PO2 electrode system uses principles similar to
those for pH measurement.

Source : ECRI, Blood Gas/pH Analyzers, H.P.C. System,

Editor. 2001. p. 1-4.

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PO2 Electrode

• This continuous reaction leads to continuous flow of electrons from the anode to
the cathode (electrical current).

• This electrical current is measured by using an ammeter (electrical current flow

meter).

• The current generated is directly proportional to the amount of dissolved oxygen

in the blood sample, which indicate PO2 in that sample.

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pH Electrode
• The pH electrode uses voltage to measure pH, rather than actual current as in
PO2 electrode.
• It compares a voltage created through the blood sample (with unknown pH) to
known reference voltage (in a solution with known pH).
• Practically, one common pH-sensitive glass electrode terminal between the two
solutions is adequate.
• This glass terminal allows the hydrogen ions to diffuse into it from each side.
• The difference in the hydrogen ions concentration across this glass terminal
creates a net electrical potential (voltage).
• A specific equation is used to calculate the blood sample pH, using the reference
fluid pH, the created voltage, and the fluid temperature.

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 Figure A specific equation is used to calculate the blood sample pH, using the
reference fluid pH, the created voltage, and the fluid temperature.

Source : Akay, M., WILEY ENCYCLOPEDIA OF BIOMEDICAL ENGINEERING. 2006,

Washington: simultaneously in Canada.

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 The pH measurement is performed using two separate
electrodes: a pH-measuring electrode and a reference
electrode.

Source : ECRI, Blood Gas/pH Analyzers, H.P.C. System,

Editor. 2001. p. 1-4.
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PCO2 Electrode
• The PCO2 electrode is a modified pH electrode.
• There are two major differences between this electrode and the pH electrode.
• The first difference is that in this electrode, the blood sample comes in contact
with a CO2 permeable membrane (such as Teflon, Silicone rubber), rather than a
pH-sensitive glass (in the pH electrode).
• The CO2 from the blood sample diffuses via the CO2 permeable (silicone)
membrane into a bicarbonate solution.
• The amount of the hydrogen ions produced by the hydrolysis process in the
bicarbonate solution is proportional to the amount of the CO2 diffused through
the silicone membrane.

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PCO2 Electrode
• The difference in the hydrogen ions concentration across the pH sensitive glass
terminal creates a voltage.
• The measured voltage (by voltmeter) can be converted to PCO2 units.
• The other difference is that the CO2 electrode has two similar electrode terminals
(silver–silver chloride).
• However, the pH electrode has two different electrode terminals (silver–silver
chloride and mercury–mercurous chloride)

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 The PCO2 electrode is a modified pH electrode. There are
two major differences between this electrode and the pH
electrode.

Source : Akay, M., WILEY ENCYCLOPEDIA OF BIOMEDICAL

ENGINEERING. 2006, Washington: simultaneously in
12/03/2022 Canada. 20
 The PCO2 electrode system uses principles similar to those for
pH measurement.

Source : ECRI, Blood Gas/pH Analyzers, H.P.C. System, Editor.

12/03/2022 2001. p. 1-4. 21
Calibration Procedures
• To assure appropriate electronic function of the electrodes, calibration
procedures are performed
• Performed automatically every 30 minutes by the ABG machine
• Performed on the pH, PCO2, PO2 electrodes
• Specific procedure for each electrode
• 2-Point Calibration
• A “low” concentration and a “high” concentration is used at both ends of the
physiological range to be measured
• Multiple-Point Calibration (3 or more points)
• Verifies whether the gas analyzer is linear or not

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Calibration Procedures
• pH Electrode
• Uses two specific buffers with approximate values of:
• 6.840 buffer
• referred to as the zero point or low point buffer
• 7.384 buffer
• high point or slope point buffer
• Each buffer is injected into the sample chamber, one at a time
• The values of the buffer that is injected, should be displayed on the ABG machine
within a specific SD (standard deviation)
• Standard deviation for pH is + .005
• If value displayed is within the SD, machine is electronically calibrated
• If value displayed is outside of the SD, machine needs to be adjusted to assure
electronic function
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Calibration Procedures
• PO2 & PCO2 Electrode
• Uses two specific concentration of gases for each electrode with approximate
concentrations of CO2 and O2
• Uses two different tanks of gas to accomplish this
• Tank One
• Low CO2 (5%) - balance
• High O2 (12% or 20%)
• Balance Nitrogen
• Tank Two
• High CO2 (10%) – slope
• O2 (0%)
• Balance Nitrogen

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Calibration Procedures
• PO2 & PCO2 Electrode
• The values calculated for the CO2 and O2 concentration should be displayed on
the ABG analyzer within a specific SD (standard deviation)
• Standard deviation for PO2 and CO2 is + 0.5
• If values displayed are within the SD, machine is electronically calibrated
• If value displayed is outside of the SD, machine needs to be adjusted to assure
electronic function

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Calibration Procedures
• Troubleshooting
• If the ABG machine will not calibrate, check:
• The buffers
• The mixed gases
• The electrode’s membrane
• The electrode itself

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Quality Control

• Must be run in every shift

• Utilize a known concentration of gases
and buffers in a vial of liquid
• Run three levels of QC
• Level 1 – Acidosis
• Level 2 – Normal
• Level 3 - Alkalosis

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