Blood Gas Analysis
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Blood Gas Analysis. Nantaya Chanarat. [email protected] Blood gas analysis is for determine :. That the patient is well oxygenated. Acid-base status of the patient = respiratory acidosis/alkalosis = metabolic acidosis/alkalosis. Blood gas parameters :

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Blood Gas Analysis

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Blood gas analysis

Blood Gas Analysis

Nantaya Chanarat

[email protected]


Blood gas analysis

Blood gas analysis is for determine :

  • That the patient is well oxygenated

  • Acid-base status of the patient

  • = respiratory acidosis/alkalosis

  • = metabolic acidosis/alkalosis


Blood gas analysis

  • Blood gas parameters :

  • ArterialVenous

  • pH 7.35-7.45

  • pO280-110 35-40

  • pCO235-45 41-51


Blood gas analysis

pH= the only way to tell if the body is acid or alkaline

Normal pH (7.35- 7.45)

Acidosis =an acid condition of the blood (acidemia, pH < 7.35)

Alkalosis =an alkaline condition of the blood (alkalemia, pH > 7.45)


Blood gas analysis

pO2 = partial pressue of oxygen in blood

- Arterial blood (80-100 mmHg)

= Lung oxygenation

- Venous blood (35-40 mmHg)

= Tissue transfer or being oxygenated


Blood gas analysis

pCO2 = pressure (tension) of dissolved CO2 in blood

- gaseous,acid

- controlled by lung

Normal ventilation = 35-45 mmHg

pCO2 -Hypoventilation

-Respiratory acidosis

pCO2 -Hyperventilation

-Respiratory alkalosis


Blood gas analysis

-

HCO3 - base excess (BE)

- non-respiratory parameter

- solution, basic

- regulated mainly by kidney

Metabolic acidosis - HCO3

alkalosis - HCO3

-

-

At pH 7.4 [HCO3/CO2] = 20:1


Blood gas analysis

Henderson-Hesselbalch equation :

pH = pKa + log

[A-]

[HA]

At pH 7.4

7.4 = 6.1 + log

1.3 = log

=

[HCO3-]

[H2CO3]

[HCO3-]

[H2CO3]

[HCO3-]

[H2CO3]

20

1


Blood gas analysis

Blood collection

Arterial > Venous

- site

- anticoagulation

- container

- transportation / storage


Blood gas analysis

Blood Gas Electrodes


Blood gas analysis

Blood Gas Analyzer

BGA, BGE, BGA plus E

Oxymeter(Co-oxymeter)

measure the % of HbO2 & total Hb

Tonometer

mix the gas with sample or standard

Other ISEs

measure various parameters as needed

etc.


Blood gas analysis

Lab. Findings

pHpCO2 [HCO3-]

Metab. Acidosis D D D

Alkalosis I I I

Res. Acidosis D I I

Alkalosis I D D


Blood gas analysis

Modified

Siggaard-

Anderson

Acid-Base

Nomogram


Blood gas analysis

Product information: TCM4

Neonatology

Wound care

Sleep medicine


Blood gas analysis

Emergency Lab. Medicine

Electrolytes

Blood gas analysis

Glucose, Urea

Amylase

Cardiac markers : CK, Troponin

etc.


Blood gas analysis

แพทย์ทำ gastric suction ทำให้ผู้ป่วยเกิด Metabolic alkalosis หลังจากนั้น แพทย์ได้ให้ HCl infusion ผล Lab ก่อนและหลังให้ HCl เป็นดังนี้

Plasma Set 1Set 2

Na 151152 mmol/L

K 2.8 6.0 mmol/L

Cl 92 134 mmol/L

TCO2 52 12 mmol/L

Urea 7.5 12.9 mmol/L

Creatinine 0.14 0.18 mmol/L

Anion gap (AG) 10 12 mEq/L

Blood

pH 7.54 7.18

H+ 28 66 mmol/L

pCO2 59 33 mmHg

HCO3 53 12 mmHg


Blood gas analysis

Early Uremic Acidosis

ผู้ป่วยชาย อายุ 64 ปี มีประวัติกินยาแก้ปวดเป็นประจำ เป็นเวลานาน

Plasma:Na 141mmol/L

K 5.7 mmol/L

Cl 115 mmol/L

TCO2 17 mmol/L

Urea 21 mmol/L

Creatinine 0.2 mmol/L

Anion gap (AG) 15 mEq/L

Blood : pH 7.29

H+ 51 mmol/L

pCO2 36 mmHg

pO2 98 mmHg

HCO3 17 mmHg

Urine pH 4.5

Creatinine clearance 26 ml/min (90-130)


Blood gas analysis

Light-hearted clinical chemistry

It was past 5 p.m. in the afternoon of Christmas Eve. I was on the PubMed making a last-minute attempt to understand a clinical syndrome. The Duty Biochemist informed me that an innovative doctor in the Neonatal ICU had been injecting faeces into the blood gas analyser on the ward, potentially putting the analyser out of use for the entire holiday period and certainly adding and extra US$1000 or so to our already strained departmental budget for the replacement of the 28-day cartridge.

We thought that the instrument was foolproof….

Recollected by Chris Lam, Hong Kong


Blood gas analysis

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