✿ yumikoyuki ✿: ABG interpretation

assalamualaikum w.b.t...

today nak story about ABG..so, what is ABG? macam dalam gambar tu, ABG stands for arterial blood gases..

apa tujuan ambik ABG?

--> untuk tengok function lung, kidney, heart [pH, PaCO2, HCO3]

apa beza ABG & VBG?

--> bezanya just location of the blood taken..ABG from artery..VBG from vein..

--> ABG a bit painful sebab kne ambik from artery which is deeper than vein..

--> both lebih kurang je..both boleh pakai for lab investigation..but ABG is gold standard untuk tengok parameters pH, PaCO2, HCO3

so bila nak kena ambik ABG?

--> bila suspect these condition:

severe shock (nak tengok PaCO2 level)
hypercapnic (tengok PaCO2 >45 mmHg)

--> Dr akan ambik ABG if patient tu ada trouble breathing..contohnya if pt ada cystic fibrosis..nak tengok severity and if pt tu perlu O2 support or not so kena ambik ABG

--> Dr akan ambik jugak untuk tengok progression of the treatments given

--> untuk check the acid-based balance..this one usually in kidney failure/ DKA pt..sebab nak rule out any complication etc

kat mana location untuk ambik ABG?

how to interpret ABG?

now..we reach the most crucial part of ABG :D

before that, this is my way of interpreting sebab nak bagi senang..if ada anyone yang ada other method, boleh share2 :)

first, kita hafal yang normal reading dulu..

acidosis alkalosis

pH <-------- 7.35 - 7.45 -------->

PaCO2 <-------- 45 - 35 -------->

HCO3 <-------- 22 - 26 -------->

to interpret:

1) tengok pH dulu untuk determine either acidosis/ alkalosis

2) the one that equal to pH is the problem (respiratory/ metabolic)

for compensation, ada 3 division:

1) uncompensated - either PaCO2/ HCO3 normal

2) partially compensated - semua abnormal

3) compensated - pH is normal

****

pH : acidosis

PaCO2/HCO3 : acidosis

= mixed acidosis (they are both the troublemakers)

pH : acidosis

eg PaCO2 : alkalosis

eg HCO3 : acidosis

=partially compensated cos one is the troublemaker (in this example the HCO3) and one is trying to fix the problem (in this example PaCO2)

pH : acidosis

PaCO2/HCO3 : acidosis

PaCO2/HCO3 : normal

=uncompensated cos one is the troublemaker but the other one isnt doing anything to fix it

pH : normal

eg PaCO2 : Acidosis

eg HCO3 : Alkalosis

= FULLY compensated. Fully compensated, the pH MUST be normal. And then we see if it is acidic normal or alkalosis normal.

**In this case, if it is 7.37, it will.be an acidic normal. Meaning the troublemaker was most likely the extremely high PaCO2 which made it acidic. And the HCO3 is trying to fix it. 💕

here yanie attach skali other way untuk interpret ABG