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Simple Method of Acid Base Balance Interpretation

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121 views

Simple Method of Acid Base Balance Interpretation

Uploaded by

Shawn McMahon
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd
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Simple Method of Acid Base Balance Interpretation


A FOUR STEP METHOD FOR INTERPRETATION OF ABGS

Usefulness

This method is simple, easy and can be used for the majority of ABGs. It only
addresses acid-base balance and considers just 3 values.

 pH,
 PaCO2
 HCO3-

Step 1. Use pH to determine Acidosis or Alkalosis.

   ph
 < 7.35  7.35-7.45  > 7.45
 Normal or
 Acidosis  Alkalosis
Compensated

Step 2. Use PaCO2 to determine respiratory effect.

   PaCO2
 < 35  35 -45 > 45
  Tends   Tends
toward  Normal toward
alkalosis acidosis
 Causes or  Causes
high pH low pH
 Neutralize Compensat  Neutralize
s low pH ed s high pH
Step 3. Assume metabolic cause when respiratory is ruled out.

 You'll be right most of the time if you remember this simple table:

 High pH Low pH
 Alkalosis Acidosis
 High
Low PaCO2 High PaCO2 Low PaCO2
PaCO2
 Metabolic Respiratory Respiratory Metabolic

 If PaCO2 is abnormal and pH is normal, it indicates compensation.


o pH > 7.4 would be a compensated alkalosis.
o pH < 7.4 would be a compensated acidosis.

These steps will make more sense if we apply them to actual ABG
values. Click here to interpret some ABG values using these steps. You
may want to refer back to these steps (click on "linked" steps or use "BACK"
button on your browser) or print out this page for reference.

Step 4. Use HC03 to verify metabolic effect

 Normal HCO3- is 22-26

Please note:

 Remember, the first three steps apply to the majority of cases, but do
not take into account:
o the possibility of complete compensation, but those cases are
usually less serious, and
o instances of combined respiratory and metabolic imbalance, but
those cases are pretty rare.
 "Combined" disturbance means HCO3- alters the pH in the
same direction as the PaCO2.
 High PaCO2 and low HCO3- (acidosis) or
 Low PaCO2 and high HCO3- (alkalosis).
Now, try some patient case studies

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