Interpretation of ABGs

Interpretation of ABGs

Interpretation of Arterial Blood Gases (ABGs)
David A. Kaufman, MD
Chief, Section of Pulmonary, Critical Care & Sleep Medicine
Bridgeport Hospital-Yale New Haven Health
Assistant Clinical Professor, Yale University School of Medicine
(Section of Pulmonary & Critical Care Medicine)

Introduction:
Interpreting an arterial blood gas (ABG) is a crucial skill for physicians, nurses, respiratory therapists, and other health care personnel. ABG interpretation is especially important in critically ill patients.

The following six-step process helps ensure a complete interpretation of every ABG. In addition, you will find tables that list commonly encountered acid-base disorders.

Many methods exist to guide the interpretation of the ABG. This discussion does not include some methods, such as analysis of base excess or Stewart’s strong ion difference. A summary of these techniques can be found in some of the suggested articles. It is unclear whether these alternate methods offer clinically important advantages over the presented approach, which is based on the “anion gap.”

6-step approach:

Step 1:  Assess the internal consistency of the values using the Henderseon-Hasselbach equation:

[H+] = 24(PaCO2)
[HCO3-]

If the pH and the [H+] are inconsistent, the ABG is probably not valid.

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