医学英文资料：Clinical Aspect of Interpretation of Arterial Blood Gases.pptVIP

Interpretation of Arterial Blood Gases Interpretation StrategiesStep 1 Was the blood gas specimen obtained acceptably? Free of air bubbles and clots? Analyzed promptly and/or iced properly? Air Contamination of Sample Step 2 Did the blood gas analyzer function properly? Was there a recent acceptable calibration of all electrodes? Was analyzer function validated by appropriate quality control? Data Quality in Blood GasesAcceptability criteria of AARC Blood collected anaerobically The specimen adequately anticoagulated A 2-4 ml sample recommended The specimen analyzed in a few minutes, otherwise stored in ice within 1 hour Equipment calibration and quality control The specimen adequately identified Step3 Determine acid-base imbalance The normal limits of pH is 7.35 - 7.45. If below 7.35, acidosis is present; If above 7.45, alkalosis is present. Otherwise look for compensation. Is pH within normal limits? Step 4the cause of acid-base imbalance? Respiratory? If PCO2 45 and pH 7.35, respiratory acidosis. If PCO2 45 and pH 7.35-7.45, then compensated respiratory acidosis If PCO2 35 and pH 7.45, respiratory alkalosis If PCO2 35 and pH 7.35-7.45, then compensated respiratory alkalosis Step 4the cause of acid-base imbalance? Metabolic? If HCO3- 22 and pH 7.35, metabolic acidosis. If HCO3- 22 and pH 7.35-7.45, then compensated metabolic acidosis If HCO3- 27 and pH 7.45, metabolic alkalosis If HCO3- 27 and pH 7.35-7.45, then compensated metabolic alkalosis Step 5 Oxygenation? Is PaO2 within normal limits of 80 to 100 mm Hg? If PaO2 50 mm Hg, severe hypoxemia is present. The Hypoxemic State Hypoxemia is defined as PaO2 80 mm Hg while breathing room air. When patients are already on oxygen it is not necessary and may be dangerous to interrupt the oxygen therapy to assess hypoxemia. Step 6Correlated with clinical picture? Are blood gas results consistent with patients clinical status? Case