Arterial blood gas

To characterize the responses to PbTx-2, five dose rates (0, 12.5, 25, 50, and 100 ig/kg/hr in 2 ml saline) were infused into the jugular catheters of rats (four per group). Heart rates, systolic and diastolic arterial blood pressures, pulse pressures, respiratory rates, core and peripheral body temperatures, lead VI0 ECCjs, and arterial blood gases were monitored. Clinical signs and behaviors were recorded by video camera. After infusion, animals were monitored for 6 hr, by which time most had either died or recovered to near baseline physiological levels. 

Acidosis Arterial blood gases Sodium bicarbonate, hyperventilation... 

Hypoxia Arterial blood gases, Ventilation, oxygen... 

Complete blood count, serum chemistries, arterial blood gases, and antiepileptic blood levels ° Urine and blood toxicological panel... 

Follow-up with arterial blood gases to determine correction and need for additional sodium bicarbonate therapy... 

Monitor the following serial laboratories for comparison to baseline values every 6 hours in the first 24 hours and daily thereafter until normalized sodium, serum creatinine, blood urea nitrogen, serum lactate, glucose, bilirubin, hemoglobin, hematocrit, platelets, prothrombin time, partial thromboplastin time, arterial blood gases, and pH. 

Arterial blood gases for evaluating partial arterial pressure of carbon dioxide (Pco2) should be considered for patients in severe distress, suspected hypoventilation, or when PEF or FEYT, is less than or equal to 30% after initial treatment. 

A suspected diagnosis of COPD should be based on the patient s symptoms and/or history of exposure to risk factors. Spirometry is required to confirm the diagnosis. The presence of a postbronchodilator FEV,/FVC ratio less than 70% [the ratio of FEV, to forced vital capacity (FVC)] confirms the presence of airflow limitation that is not fully reversible.1,2 Spirometry results can further be used to classify COPD severity (Table 12-1). Full pulmonary function tests (PFTs) with lung volumes and diffusion capacity and arterial blood gases are not necessary to establish the diagnosis or severity of COPD. 

Obtain spirometry measurements to assess airflow limitation and aid in severity classification and treatment decisions. Measure arterial blood gases if FEV is less than 40% predicted or if the patient has clinical signs suggestive of respiratory failure or right heart failure. 

Arterial blood gases with a normal or elevated pH indicates metabolic alkalosis that may or may not be compensated. 

Obtain blood urea nitrogen (BUN), serum creatinine (SCr), calculated fractional excretion of sodium (FeNa), serum electrolytes, and arterial blood gases. 

Monitor serum electrolytes and arterial blood gases regularly. Correct metabolic acidosis slowly to prevent the development of metabolic alkalosis or other electrolyte abnormalities. 

Arterial blood gases, serum electrolytes, physical examination findings, the medical history, and the patient s recent medications must be reviewed in order to establish the etiology of a given acid-base disturbance. 

Serial arterial blood gases and serum chemistries should... 

Abnormal arterial blood gases (ABCs) due to hypoxia and respiratory or metabolic acidosis... 

Arterial blood gases are beneficial primarily in patients with severe pneumonia. 

Etoposide Blood pressure, respiratory rate, serum pH, serum bicarbonate with arterial blood gases, and evaluation of anion gap if necessary... 

ABG Arterial blood gases ARC AIDS-related complex... 

Characteristic symptoms include fever and dyspnea clinical signs are tachypnea, with or without rales or rhonchi, and a nonproductive or mildly productive cough. Chest radiographs may show florid or subtle infiltrates or may occasionally be normal, although infiltrates are usually interstitial and bilateral. Arterial blood gases may show minimal hypoxia (Pao2 80 to 95 mm Hg) but in more advanced disease may be markedly abnormal. 

Peripheral white blood cell count normal or slightly elevated Abnormal arterial blood gases (hypoxemia and, rarely, hypercarbia)... 

Arterial blood gases are measured to determine oxygenation and acid-base status (Fig. 74-1). Low pH values (less than 7.35) indicate acidemia, whereas high values (greater than 7.45) indicate alkalemia. The PaC02 value helps to determine if there is a primary respiratory abnormality, whereas the I IC( )3 concentration helps to determine if there is a primary metabolic abnormality. Steps in acid-base interpretation are described in Table 74-2. 

FIGURE 74-1. Analysis of arterial blood gases. (HC03, bicarbonate Pco2, partial pressure of carbon dioxide.)... 

Obtain arterial blood gases (ABGs) and electrolytes simultaneously. 

Arterial blood gases are the primary tools for evaluation of therapeutic outcome. They should be monitored closely to ensure resolution of simple acid-base disorders without deterioration to mixed disorders due to compensatory mechanisms. For example, arterial blood gases should be obtained every 2 to 4 hours during the acute phase of respiratory acidosis and then every 12 to 24 hours as acidosis improves. 

Arterial blood gases may reveal metabolic acidosis and a low Pa02. 

Significant changes in arterial blood gases are not usually present until the FEV is less than 1 L. At this stage, hypoxemia and hypercapnia may become chronic problems. Hypoxemia usually occurs initially with exercise but develops at rest as the disease progresses. 

In acute exacerbations of COPD, white blood cell count, vital signs, chest x-ray, and changes in frequency of dyspnea, sputum volume, and sputum purulence should be assessed at the onset and throughout the exacerbation. In more severe exacerbations, arterial blood gases and oxygen saturation should also be monitored. 

Blood pressure, arterial blood gases, oxygen saturation, cyanide and thiocyanate concentrations, anion gap, lactate levels... 

First, the airway should be cleared of vomitus or any other obstruction and an oral airway or endotracheal tube inserted if needed. For many patients, simple positioning in the lateral decubitus position is sufficient to move the flaccid tongue out of the airway. Breathing should be assessed by observation and oximetry and, if in doubt, by measuring arterial blood gases. Patients with respiratory insufficiency should be intubated and mechanically ventilated. The circulation should be assessed by continuous monitoring of pulse rate, blood pressure, urinary output, and evaluation of peripheral perfusion. 

Iloffer, E.P. "Arterial Blood Gases/ Version 5, Lippincott Williams Wilkins, Philadelphia, PA, 1997. 

Blood samples are used for many measurements, including arterial blood gases, leukocyte counts, cultures, and cytokine determinations. During the observation period, 1-mL blood samples can easily be obtained through the arterial catheter using a 3-way stopcock. 

Hypercarbia on examination of arterial blood gases is nonspecific and generally a late finding. 

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