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Arterial Blood Gases An arterial blood gas (ABG) test measures the levels of oxygen and carbon dioxide

e in the blood to determine how well your lungs are working. It evaluates the ability of your lungs to move oxygen into the blood and to remove carbon dioxide from the blood. An ABG measures: Partial pressure of oxygen (PaO2). The oxygen level indicates how well oxygen is able to move from the airspace of the lungs into the blood. Partial pressure of carbon dioxide (PaCO2). The carbon dioxide level indicates how well carbon dioxide is able to move out of the blood into the airspace of the lungs and out with exhaled air. pH. The pH is a measure of hydrogen ion (H+) in blood which indicates the acid or base (alkaline) nature of blood. A pH of less than 7 is acidic, and a pH greater than 7 is called basic (alkaline). The pH of blood is usually close to 7.4. Bicarbonate (HCO3). Buffers are chemical substances that keep the pH of blood within a normal range. Bicarbonate is the most important buffer in the blood. Oxygen content (O2CT) and oxygen saturation (O2Sat) values. Like the PaO2, these values provide information about the amount of oxygen in the blood. Abnormal values for oxygen, carbon dioxide, and pH can be caused by changes in: Lung function. Heart and circulation function. Kidney function. The ability of the body to use food for energy (metabolism). The use of some medications. Most blood tests are done on a sample of blood taken from a vein, after the blood has already passed through the body's tissues where the oxygen is used up and carbon dioxide is produced. An ABG test is usually taken from the radial artery in the wrist. Arteries in the elbow (brachial) and groin (femoral) may also be used. Why It Is Done An arterial blood gas (ABG) test is done to: Evaluate severe breathing problems and lung diseases, such as asthma, cystic fibrosis, or chronic obstructive pulmonary disease. It may also be used to monitor treatment for problems that affect breathing. Evaluate your need for extra oxygen or help with breathing (mechanical ventilation). Qualify you for home oxygen use. Measure the acid-base level in heart or kidney failure, uncontrolled diabetes, sleep disorders, a drug overdose, or a severe infection. Detect exposure to carbon monoxide and other chemicals. Results An arterial blood gas (ABG) test can measure the levels of oxygen and carbon dioxide in the blood to determine how well the lungs are working. The levels of blood gases (oxygen and carbon

dioxide) in an artery are measured as partial pressures (Pa). Having more than one disease or condition can lead to results that need more careful review by your health professional. Abnormal partial pressure of oxygen (PaO2) A high PaO2 may indicate rapid breathing (hyperventilation). High PaO2 levels may also result from receiving oxygen therapy. A low PaO2 may indicate the presence of pneumonia, chronic obstructive pulmonary disease (COPD) or other lung diseases (such as fibrosis), certain heart disorders (such as heart failure), pulmonary edema, or pulmonary embolism. Abnormal partial pressure of carbon dioxide (PaCO2) A low PaCO2 may be caused by hyperventilation, pulmonary embolism, or pregnancy. A high PaCO2 may indicate chronic obstructive pulmonary disease (COPD), a severe head injury, a disorder that is characterized by obesity (obesity hypoventilation syndrome or pickwickian syndrome), hypoventilation, or disturbed sleep. Hypoventilation can occur in certain diseases affecting the nerves and muscles (such as amyotrophic lateral sclerosis). Sedatives and narcotics can raise PaCO2 values. Abnormal pH A low pH with high partial pressure of carbon dioxide (PaCO2) and high or normal bicarbonate (HCO3) levels is called respiratory acidosis and may indicate conditions that prevent carbon dioxide from being exhaled. These conditions include asthma, chronic obstructive pulmonary disease (COPD), pneumonia, chest injury, drug overdose, massive obesity, or disorders affecting the brain or nervous system. A high pH with low PaCO2 and normal or low HCO3 levels is called respiratory alkalosis and may result from hyperventilation (caused by certain medications, fever, anxiety, high room temperature, breathing in a low amount of oxygen, or severe pain), heart failure, heart attack, disorders of the brain or nervous system, anemia, carbon monoxide poisoning, pulmonary embolism, or shock. Respiratory alkalosis may also occur in late pregnancy and during labor and delivery. A low pH with normal or low PaCO2 and low HCO3 levels is called metabolic acidosis and may result from strenuous exercise, poisoning (especially by aspirin or certain types of alcohol), severe diarrhea, liver disease, shock, kidney disease, or uncontrolled diabetes. A high pH with normal or high PaCO2 and high HCO3 levels is called metabolic alkalosis and may result from prolonged vomiting, diuretic therapy, receiving large doses of corticosteroids, eating large amounts of natural black licorice, or eating large amounts of baking soda or antacids. Abnormal bicarbonate (HCO3) High HCO3 levels may be caused by persistent vomiting, blood transfusions, and excessive use of substances containing bicarbonate (especially antacids). Conditions such as chronic obstructive pulmonary disease (COPD), fluid in the lungs (pulmonary edema), heart disease, Cushing's disease, and Conn's syndrome can also raise blood bicarbonate levels.

Hyperventilation, aspirin or alcohol overdose, frequent diarrhea, dehydration, severe malnutrition, severe burns, and shock can lower bicarbonate values. Low bicarbonate values also can be caused by conditions such as liver or kidney disease, a massive heart attack, hyperthyroidism, or uncontrolled diabetes. Medications that can raise HCO3 values include diuretics, such as furosemide (Lasix) and metolazone (such as Zaroxolyn), and corticosteroids, such as hydrocortisone and prednisone. Medications that can lower HCO3 levels include acetazolamide (such as Diamox), methicillin (Staphcillin), nitrofurantoin (such as Macrobid or Macrodantin), and tetracycline (such as Achromycin or Vibramycin).

Abnormal oxygen saturation (O2Sat) A low O2Sat may indicate decreased levels of oxygen in the air, chronic obstructive pulmonary disease (COPD), pneumonia, certain heart disorders (such as heart failure), pulmonary edema, pulmonary embolism, or hypoventilation (which can occur in certain diseases affecting the nerves and muscles, such as amyotrophic lateral sclerosis). What Affects the Test Factors that can interfere with your test and the accuracy of the results include: A fever, which may raise the oxygen and carbon dioxide values. An abnormally low body temperature (hypothermia) lowers these values. Severe anemia or polycythemia. Smoking just before the test or being exposed to secondhand smoke, carbon monoxide, or certain paint or varnish removers in closed or poorly ventilated areas, which may lower oxygen saturation (O2Sat) values without affecting partial pressure of oxygen (PaO2) values. Air bubbles in the syringe used to collect the blood sample. Testing a blood sample that is not fresh (is more than 1 hour old). What To Think About Arterial blood gas values alone do not provide enough information to diagnose a problem. For example, they cannot distinguish between lung and heart problems. Arterial blood gas values are most helpful when they are considered along with other examinations and test results. An arterial blood gas (ABG) test is often done for a person who is in the hospital because of severe injury or illness. The test can help determine whether the person's lungs and kidneys are working properly and whether the body is using energy normally. An ABG test may be most useful when a person's breathing rate is increased or decreased or when the person has very high blood sugar (glucose) levels, a severe infection, or heart failure. If several blood samples are needed, a thin tube (arterial catheter) may be placed in an artery. Blood can then be collected when needed.