Arterial Blood Gases Made Easy by Iain Hennessey, Alan Japp

By Iain Hennessey, Alan Japp

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TO GUIDE AND MONITOR TREATMENT Rf'&uliU" ABC momtoring can help provide early warning of do;>lcriorabun and jl1d~e the cffe<:tivl;>ness of therapeutic inlprventiol\:>, It i:o essential for tilrating 0, therapy in patients with chronic tyl't! lilurc and for optimising \'enhlator YffinKS. g. e\ Suspeded severe hypoxoemlO Very low Of unrecordable 0, saturaTion; CYOrlO$i~ Severe. lOboIic ocidoslsl At,. g. in in poncreohhsl Guiding II ealli"'" and ~itonng respon5e - Mechanically ventiloted JXItients Potients receiVing non-Invosive o"i,ted vcntilolton Patients w,1t.

3 SO " 4C " " Nofmal1af9l 30 20 10 0 0 2 0 15 , • • 30 45 80 "'\erial PaC~ (k,Pa) 10 " """ OJ """" Figu,.. 16 The ~rom_ 3. "CSS, otlu:r tlum a rise i1l p~ thai actl 10 lower blood pH. 1"oed production or n>duced. renal excretIOn) or through exct'SSi"'e loss of base (HC~). l1culaling the anion gap (sec over) may help to ~tab~h the caU1Ie uf a metabolic acidosis. Metabolic aridOf;is is recognised on an AI}(; by low HCo, (and negative bas<' exC('5S (BE». :0:!. If resprratory com~bonIS overwhelmed, an acidaf'mia will result.

Tration of free hydfoR,en ions (H') in II solution. J wro:l1y in nanomoles per litre (nmol/L) or as pi I (sover).. igh pH) are alkalinf'. The POint ilt which a substance changes from alkah to acid is lhc neutral point (pH :z 7, H' s 100 nnwl/ L). S H' when It l~ dissolved in ~lution Acids ttwrefotf" increase ~ H' concentration of the solutiun (lower the pH). c;olved III solution. R"lSeS therefore lower the H' concentration of a solution (raUlt! the pH). ; on the surrounding H' concentration. Buffers lhcrdon> rl'Sist big changt:lll in H' concentration.

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