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2.6 - Obtaining and Interpretation of Results from Blood Gas Samples (Acid–Base Balance and Disorders)

from Section 2 - Diagnosis, Assessment, Investigation, Monitoring and Data Interpretation

Published online by Cambridge University Press:  27 July 2023

By
Ed McIlroy
Edited by
Ned Gilbert-Kawai ,
Debashish Dutta  and
Carl Waldmann
Ned Gilbert-Kawai
Affiliation:
The Royal Liverpool Hospital
Debashish Dutta
Affiliation:
Princess Alexandra Hospital NHS Trust, Harlow
Carl Waldmann
Affiliation:
Royal Berkshire Hospital, Reading
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Summary

Key Learning Points

  1. 1. Whilst the radial artery is a common sample site, 24–27 per cent of patients will have a negative modified Allen’s test (no/minimal ulnar supply).

  2. 2. Remember to expel air and heparin from the syringe to avoid sample contamination.

  3. 3. Errors can be associated with sample collection, machine processing and interpretation.

  4. 4. Metabolic acidosis can be high anion gap (MUDPILES) or normal anion gap (PANDA RUSH).

  5. 5. Stewart’s approach to acid–base disturbance considers the strong ion difference (SID), total weak acid concentration (Atot) and partial pressure of carbon dioxide (PaCO2).

Keywords

ABGABG errorsABG interpretationStewart’s acid–base approach
Type
Chapter
Information
Intensive Care Medicine
The Essential Guide
 , pp. 37 - 42
Publisher: Cambridge University Press
Print publication year: 2021

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References

References and Further Reading

Baird, G. Preanalytical considerations in blood gas analysis. Biochemia Medica 2013;23:19–27.CrossRefGoogle ScholarPubMed
Story, D. Stewart acid–base: a simple bedside approach. Anesth Analg 2016;123:511–15.CrossRefGoogle Scholar
Yentis, S, Hirsch, N, Ip, J. Anaesthesia, Intensive Care and Perioperative Medicine A–Z: An Encyclopaedia of Principles and Practice, 6th edn. Edinburgh: Elsevier; 2018.Google Scholar

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