Analysis Of ABG

ABG

Arterial blood gases

pH

disorder
different disorders 3
respiratory

metabolic

normal values

pH=7.35 - 7.45
PaCO2 = 35 - 45 mmHg
PaO2 = 80 - 100 mmHg
HCO3 = 22 - 26 mlEq/L
anion gap
HAGMA
High anion gap metabolic acidosis
anion gap

anion gap

measured cations and anions

acidosis
accumulation of non volatile acids or loss of bicarbonate
Na-(Cl+HCO3) =8-14 mEq/L
anions and cations
anion gap
balance
cations=anions
Na+unmeasured cations=(Cl +HCO3)+unmeasured anions
Na-(Cl+HCO3)=UA-UC
UA-UC
anion gap
albumin

hypoalbuminaemia

albumin 50%
anion gap 75%
ABG
Albumin

STEP 1

20

anion gap
) AG = Na-(Cl+HCO3
normal value =9-16

anion gap
acidosis

20
HAGMA is most likely present

HAGMA=high anion gap metabolic acidosis

pH
ABG

30
anion gap
high anion gap metabolic acidosis
pH and HCO3

anion gap
metabolic disorder
delta gap HCO3

delta gap =AG-12

delta gap

delta gap+HCO3

mmol/L26

coexisting metabolic alkalosis

mmol/L 24

( coexisting NAGMA (normal anion gap metabolic acidosis

metabolic disorder

metabolic disorder

26 - 24
HAGMA
HAGMA

Values
disorders
735
745

acidaemia
alkalaemia
HCO3

STEP 2

pH
pH

pH
metabolic acidosis

PaCO2
pH
respiratory acidosis

HCO3
pH
metabolic alkalosis

PaCO2
pH
respiratory alkalosis

respiratory disorder

Disorder

respiratory disorder

STEP 3
acute or chronic

: metabolic acidosis
PaCO2=(1.5HCO3+8)+/-2

: metabolic alkalosis
( PaCO2=40+0.7(measured HCO3-24
: Respiratory acidosis

Acute : HCO3 increases 1mmol/L for every 10 mmHg increase in *

PaCO2. ..and
pH decreases 0.008 per 1mmHg inc. in PaCO2

Chronic : HCO3 inc. 3.5 mmol/L for every 10 mmHg inc. in PaCO2*
and pH decrease 0.003 per 1 mmHg inc. in PaCO2
: Respiratory alkalosis

acute : HCO3 decr. 2 mmol/L for every 10 mmHg decr. in PaCO2 *

pH incr. 0.008 per 1 mmHg decrease in PaCO2

chronic : HCO3 decrease 5mmol/L for every 10 mmHg increase in *

PaCO2
and pH increase 0.003 per 1mmHg decr.in PaCO2

ABG

full analysis

diagnosis
of any disorder