ABG analysis & Acid-Base Disorders

Posted by e-Medical PPT Tuesday, June 24, 2014
Discuss simple steps in analyzing ABGs
Calculate the anion gap
Calculate the delta gap
Differentials for specific acid-base disorders

Steps for ABG analysis
What is the pH? Acidemia or Alkalemia?
What is the primary disorder present?
Is there appropriate compensation?
Is the compensation acute or chronic?
Is there an anion gap?
If there is a AG check the delta gap?
What is the differential for the clinical processes?

Respiratory Acidosis
Acute: for every 10 increase in pCO2  -> HCO3 increases by 1  and  there is a decrease of 0.08 in pH MEMORIZE
Chronic: for every 10 increase in pCO2 -> HCO3 increases by 4 and there is a decrease of 0.03 in pH
Respiratory Alkalosis
Acute: for every 10 decrease in pCO2 -> HCO3 decreases by 2 and there is a increase of 0.08 in PH MEMORIZE
Chronic: for every 10 decrease in pCO2 -> HCO3 decreases by 5 and there is a increase of 0.03 in PH

Metabolic Acidosis
Winter’s formula: pCO2 = 1.5[HCO3] + 8 ± 2 MEMORIZE
If serum pCO2 > expected pCO2 -> additional respiratory acidosis
Metabolic Alkalosis
For every 10 increase in HCO3 -> pCO2 increases by 6
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