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Blood Gas Analysis

Blood Gas Analysis. Nantaya Chanarat. aschi002@chiangmai.ac.th. Blood gas analysis is for determine :. That the patient is well oxygenated. Acid-base status of the patient = respiratory acidosis/alkalosis = metabolic acidosis/alkalosis. Blood gas parameters :

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Blood Gas Analysis

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  1. Blood Gas Analysis Nantaya Chanarat aschi002@chiangmai.ac.th

  2. Blood gas analysis is for determine : • That the patient is well oxygenated • Acid-base status of the patient • = respiratory acidosis/alkalosis • = metabolic acidosis/alkalosis

  3. Blood gas parameters : • Arterial Venous • pH 7.35-7.45 • pO2 80-110 35-40 • pCO2 35-45 41-51

  4. pH= the only way to tell if the body is acid or alkaline Normal pH (7.35- 7.45) Acidosis =an acid condition of the blood (acidemia, pH < 7.35) Alkalosis =an alkaline condition of the blood (alkalemia, pH > 7.45)

  5. pO2 = partial pressue of oxygen in blood - Arterial blood (80-100 mmHg) = Lung oxygenation - Venous blood (35-40 mmHg) = Tissue transfer or being oxygenated

  6. pCO2 = pressure (tension) of dissolved CO2 in blood - gaseous,acid - controlled by lung Normal ventilation = 35-45 mmHg pCO2 -Hypoventilation -Respiratory acidosis pCO2 -Hyperventilation -Respiratory alkalosis

  7. - HCO3 - base excess (BE) - non-respiratory parameter - solution, basic - regulated mainly by kidney Metabolic acidosis - HCO3 alkalosis - HCO3 - - At pH 7.4 [HCO3/CO2] = 20:1

  8. Henderson-Hesselbalch equation : pH = pKa + log [A-] [HA] At pH 7.4 7.4 = 6.1 + log 1.3 = log = [HCO3-] [H2CO3] [HCO3-] [H2CO3] [HCO3-] [H2CO3] 20 1

  9. Blood collection Arterial > Venous - site - anticoagulation - container - transportation / storage

  10. Blood Gas Electrodes

  11. Blood Gas Analyzer BGA, BGE, BGA plus E Oxymeter(Co-oxymeter) measure the % of HbO2 & total Hb Tonometer mix the gas with sample or standard Other ISEs measure various parameters as needed etc.

  12. Lab. Findings pHpCO2 [HCO3-] Metab. Acidosis D D D Alkalosis I I I Res. Acidosis D I I Alkalosis I D D

  13. Modified Siggaard- Anderson Acid-Base Nomogram

  14. Product information: TCM4 Neonatology Wound care Sleep medicine

  15. Emergency Lab. Medicine Electrolytes Blood gas analysis Glucose, Urea Amylase Cardiac markers : CK, Troponin etc.

  16. แพทย์ทำ gastric suction ทำให้ผู้ป่วยเกิด Metabolic alkalosis หลังจากนั้น แพทย์ได้ให้ HCl infusion ผล Lab ก่อนและหลังให้ HCl เป็นดังนี้ Plasma Set 1Set 2 Na 151152 mmol/L K 2.8 6.0 mmol/L Cl 92 134 mmol/L TCO2 52 12 mmol/L Urea 7.5 12.9 mmol/L Creatinine 0.14 0.18 mmol/L Anion gap (AG) 10 12 mEq/L Blood pH 7.54 7.18 H+ 28 66 mmol/L pCO2 59 33 mmHg HCO3 53 12 mmHg

  17. Early Uremic Acidosis ผู้ป่วยชาย อายุ 64 ปี มีประวัติกินยาแก้ปวดเป็นประจำ เป็นเวลานาน Plasma:Na 141mmol/L K 5.7 mmol/L Cl 115 mmol/L TCO2 17 mmol/L Urea 21 mmol/L Creatinine 0.2 mmol/L Anion gap (AG) 15 mEq/L Blood : pH 7.29 H+ 51 mmol/L pCO2 36 mmHg pO2 98 mmHg HCO3 17 mmHg Urine pH 4.5 Creatinine clearance 26 ml/min (90-130)

  18. Light-hearted clinical chemistry It was past 5 p.m. in the afternoon of Christmas Eve. I was on the PubMed making a last-minute attempt to understand a clinical syndrome. The Duty Biochemist informed me that an innovative doctor in the Neonatal ICU had been injecting faeces into the blood gas analyser on the ward, potentially putting the analyser out of use for the entire holiday period and certainly adding and extra US$1000 or so to our already strained departmental budget for the replacement of the 28-day cartridge. We thought that the instrument was foolproof…. Recollected by Chris Lam, Hong Kong

  19. ถ้าทำไม่ถูกต้อง อย่าทำเสียดีกว่า

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