Making ABG interpretation easy

Published on 09/04/2015 by admin

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Last modified 09/04/2015

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1.9 Making ABG interpretation easy

The golden rule for making ABG interpretation easy is to assess pulmonary gas exchange and acid base status independently.

Assessing pulmonary gas exchange

• Using the algorithm opposite, classify gas exchange into one of the four possible categories.
• If there is type 1 respiratory impairment, assess severity of hypoxaemia (box 1)
• If there is type 2 respiratory impairment, establish whether it is chronic or acute, then assess severity of hypercapnia and hypoxaemia (boxes 1 & 2)
• If the category is hyperventilation, determine whether it is primary or secondary.

Box 1.9.1 Assessing hypercapnia severity

Severity is not related to absolute PaCO2 value but to the rate of PaCO2 rise and degree of blood pH derangement (pH < 7.25 = severe acidaemia). The presence of exhaustion is also an ominous sign.

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