Arterial blood gas analysis

ANALEPTICS. After administration of an analeptic, the nurse carefully monitors the patient s respiratory rate and pattern until the respirations return to normal. The nurse monitors the level of consciousness, the blood pressure and pulse rate at 5- to 15-minute intervals or as ordered by the primary health care provider. The nurse may draw blood for arterial blood gas analysis at intervals to determine the effectiveness of the analeptic, as well as the need for additional drug therapy. It is... 

Frequently monitor both ethylene glycol levels and acid-base balance, as determined by serum electrolyte (anion gap) or arterial blood gas analysis... 

Perform arterial blood gas analysis and correct respiratory dysfunction by clearing the airways, giving oxygen and perform artificial (mechanical) respiration if required. Metabolic acidosis must also be treated by giving sodium bicarbonate according to the results of arterial pH and blood gas analyses. 

Kidney failure requires special attention because of metformin accumulation. Severe lactacidotic coma despite normal renal function has been reported in a 35-year-old diabetic man taking metformin and alcohol (Ryder, 1984). While fasting plasma lactate concentrations remained unaltered after metformin, a rise was noted in response to meals (from 1.4 0.1 to 1.8 0.2 mM) (Pedersen et al., 1989). Arterial blood gas analysis in one case revealed a pH of 6.76 and a bicarbonate level of 1.6 mM before treatment of lactacidosis. After therapy, which included oxygen, volume expansion and haemodialysis, the patient completely recovered (Gan et al., 1992). 

Mahutte CK. On-Une arterial blood gas analysis with optodes current status. Clin Biochem 1998 31 119-30. 

Durbin CG, Rostow SK. More reliable oximetry reduces the frequency of arterial blood gas analysis and hastens weaning after cardiac surgery. A prospective, randomized trial of the clinical impact of a new technology. Grit Care Med 2002 30 ... 

Initial laboratory studies showed a relatively large anion gap of 34 mmol/L (reference range = 9-15 mmol/L). An arterial blood gas analysis confirmed the presence of a metabolic acidosis. Mr. Martini s blood alcohol level was only slightly elevated. His serum glucose was 68 mg/dL (low normal). 

Pearl Jones was admitted to the intensive-care unit alter a car accident with approximately 3 L of blood loss three days ago. She is semiconscious but irritable and has a blood pressure (BP) of 92/40 mm Hg, pulse (P) of 140 beats/minute, and respiration (R) of 38 breaths/minute, and her skin is cool and pale with pale mucous membranes. Arterial blood-gas analysis reveals a pH of 7.32, Pco of 33 mm Hg, of 70 percent, and HCO3 of 14 mEq/L. Urine output is 200 mL for the past 24 hours. Diagnostic tests ordered include an electrolyte panel (Na% K, CP, and CO ). What additional data would be beneficial to determine care measures for Ms. Jones ... 

Clinical assessment of pulmonary status is based on history, auscultation and noninvasive pulse oximetry/arterial blood gas analysis on room air. Chest radiography and spirometry are indicated only in patients with known or suspected significant pulmonary disease. Chronic pleural effusion may require preoperative drainage to support respiratory compensation of renal acidosis, the more so if sedation is planned. Current medication regimens should be optimized. 

Abbreviations IV, invasive mechanical ventilation NIV, noninvasive mechanical ventilation ABGA, arterial blood gas analysis. 

To evaluate the long-term reliability of MRF28 and its predictive ability for health care utilization, a multinational three-year follow-up study on CRF (Quality of Life Evaluation and Survival Study, QuESS) is underway, involving 73 researchers in nine countries (26). Preliminary data from QuESS show that whereas baseline spirometry, exercise performance, and arterial blood gas analysis are not able to discriminate between patients who will or will not survive, the SGRQ and MRF28 are good predictors of mortality in very severe respiratory patients. 

Raised metHb levels can falsely elevate the calculated oxygen saturation on arterial blood gas analysis. A saturation gap wiU occur when there is a difference between the O2 saturation measured on pulse oximetry and the O2 saturation calculated on arterial blood gases which may indicate methaemoglobinaemia. 

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