An arterial blood gas (ABG) is a blood test that is performed using blood from an artery.

It involves puncturing an artery with a thin needle and syringe and drawing a small volume of blood. The most common puncture site is the radial artery at the wrist, but sometimes the femoral artery in the groin or other sites are used. The blood can also be drawn from an arterial catheter. The test is used to determine the pH of the blood, the partial pressure of carbon dioxide and oxygen, and the bicarbonate level. Many blood gas analyzers will also report concentrations of lactate, hemoglobin, several electrolytes, oxyhemoglobin, carboxyhemoglobin and methemoglobin. ABG testing is mainly used in pulmonology, to determine gas exchange levels in the blood related to lung function, but has a variety of applications in other areas of medicine. Combinations of disorders can be complex and difficult to interpret, so calculators, nomograms, and rules of thumb
[1] [2]

are commonly used

The machine used for analysis aspirates this blood from the syringe and measures the pH and the partial pressures of oxygen and carbon dioxide. The bicarbonate concentration is also calculated. These results are usually available for interpretation within five minutes. Two methods have been used in medicine in the management of blood gases of patients in hypothermia: pH-stat method and alpha-stat method. Recent studies suggest that the -stat method is superior. pH-stat: the arterial carbon dioxide tension (paCO2) is maintained at 5.3 kPa (40 mmHg) and the pH is maintained at 7.40 when measured at the actual patient temperature. It is then necessary to add CO2 to the sample to calculate results. -stat (alpha-stat): the arterial carbon dioxide tension and the pH are maintained at 5.3 kPa (40mmHg) and 7.40 when measured at +37C. When a patient is cooled down, the pH-value will increase and the pCO2-value and the pO2-value will decrease with lowering of the temperature if measured at the patients temperature. Both the pH-stat and alpha-stat strategies have theoretical disadvantages. -stat method is the method of choice for optimal myocardial function. The pH-stat method may result in loss of autoregulation in the brain (coupling of the cerebral blood flow with the metabolic rate in the brain). By increasing the cerebral blood flow beyond the metabolic requirements, the pH-stat method may lead to cerebral microembolisation and intracranial hypertension Analyte Range Interpretation

pH

7.357.45

The pH or H+ indicates if a patient is acidemic (pH < 7.35; H+ >45) or alkalemic (pH > 7.45; H+ < 35).

H+

3545 nmol/L (nM)

See above.

PaO2

A low PaO2 indicates that the patient is not oxygenating properly, and is hypoxemic. (Note that a low PaO2 is not required for the patient to 9.313.3kPa or have hypoxemia.) At a PaO2 of less than 60 mm Hg, supplemental oxygen 80100 mmHg should be administered. At a PaO2 of less than 26 mmHg, the patient is at risk of death and must be oxygenated immediately.[citation needed]

PaCO2

The carbon dioxide partial pressure (PaCO2) is an indicator of CO2 production and elimination: for a constant metabolic rate, the PaCO2 is determined entirely 4.76.0 kPa or by its elimination through ventilation.[7] A high PaCO2 (respiratory acidosis, 3545 mmHg alternatively hypercapnia) indicates underventilation (or, more rarely, a hypermetabolic disorder), a low PaCO2 (respiratory alkalosis, alternatively hypocapnia) hyper- or overventilation.

HCO3

The HCO3 ion indicates whether a metabolic problem is present (such as ketoacidosis). A low HCO3 indicates metabolic acidosis, a high 2226 mmol/L HCO3 indicates metabolic alkalosis. As this value when given with blood gas results is often calculated by the analyzer, correlation should be checked with total CO2 levels as directly measured (see below).

SBCe

21 to 27 mmol/L

the bicarbonate concentration in the blood at a CO2 of 5.33 kPa, full oxygen saturation and 37 degrees Celsius.[8]

Base excess

2 to +2 mmol/L

The base excess is used for the assessment of the metabolic component of acidbase disorders, and indicates whether the patient has metabolic acidosis or metabolic alkalosis. Contrasted with the bicarbonate levels, the base excess is a calculated value intended to completely isolate the non-respiratory portion of the pH change.[9]

total CO2(tCO2 (P)c)

25 to 30 mmol/L

This is the total amount of CO2, and is the sum of HCO3 and PCO2 by the formula: tCO2 = [HCO3] + *PCO2, where =0.226 mM/kPa, HCO3 is expressed in millimolar concentration (mM) (mmol/l) and PCO2 is expressed in kPa [10]

O2 Content (CaO2, CvO2, CcO2)

vol% (mL oxygen/dL blood)

This is the sum of oxygen dissolved in plasma and chemically bound to hemoglobin as determined by the calculation: CaO2 = (PaO2 * 0.003) + (SaO2 * 1.34 * Hgb) where hemoglobin concentration is expressed in g/dL