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... 

Carbon dioxide devices were originally developed by Severinghaus and Bradley (59) to measure the partial pressure of carbon dioxide in blood. This electrode, still in use today (in various automated systems for blood gas analysis), consists of an ordinary glass pH electrode covered by a carbon dioxide membrane, usually silicone, with an electrolyte (sodium bicarbonate-sodium chloride) solution entrapped between them (Figure 6-17). When carbon dioxide from the outer sample diffuses through the semipermeable membrane, it lowers the pH of the inner solution ... 

Based on material from R. C. Kory (1970) and on Audio-Digest Fndn "Blood Gas Analysis" (Int Med Series 19 No. 17, Sept. 1, 1972). (Numbers and letters refer to acid-base diagnosis diagram [I-187A], flow-cTTart [I-187C], and table [1-188].)... 

Audio Digest Fndn., Blood Gas Analysis, Int. Med. Series 19 (17), Sept. 1, 1972. 

As arterial C02 tension is practically identical to alveolar C02 partial pressure, it can be used as a surrogate measurement. This is desirable as measuring arterial C02 tension involves only a simple blood gas analysis. The term Paco2, therefore, becomes Paco2 and so the equation is often written as... 

Shi ZC Study on lung function and blood gas analysis of nickel carbonyl workers. Sci Total Environ 148(2/3) 299-301, 1994... 

In incompletely filled tubes, the effects were much greater and lactic dehydrogenase increased from 113 units in the control to 172 units in a specimen containing 3 ml in a 10-ml tube. Shipping 5 ml of heparinized blood specimens for pH and blood gas analysis did not affect pH or pCOa, but PO2 showed modest increases ranging from 0.5 to 4.5 mm Hg (M4). Other investigators have reported similar findings (D6, S29). 

If heparin comprises 10% or more of the total volume of a sample for blood gas analysis, errors in measurements of carbon dioxide pressure, bicarbonate concentration, and base excess may occur. 

Digital necrosis. An 18-year-old woman, with a history of severe anorexia nervosa of 5 years duration, who acknowledged regular use of tobacco and cannabis, was hospitalized for necrosis of the left index and thumb that had occurred shortly after left radial artery puncture for blood gas analysis. Acrocyanosis of the four limbs had been present since the onset of anorexia nervosa. Arteriography of the upper limbs showed major spasm of the left radial and cubital arteries and thromboses in the left interdigital arteries of the left index and thumb. The distal portions of the arteries were then on the left and on the right. The necrotic lesions healed after intravenous administration of ilomedine and interruption of tobacco and cannabis. Acrocyanosis of the four limbs persisted . 

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

Blood pressure, ECG, blood gas analysis, urine output and respiration are to be monitored. To correct coagulation parameters, blood transfusion may be needed. 

Shoji, S., Esashi, M., Micro flow cell for blood gas analysis realizing very small sample volume. Sensors Actuators B 1992, 8(2), 205-208. 

Optional ECG, ocular investigations, skeletal growth (DEXA), blood gas analysis... 

Antibodies Immunoglobulins Morphometry Cardiac assessment Amniotic fluid Umbilical cord blood flow Umbilical cord blood for TK/blood gas analysis... 

Ventilation needs should be assessed, if necessary supported by blood gas analysis. A mixed respiratory and metabolic acidosis is common. Hypoxia may be corrected by supplementing the inspired air with oxygen but mechanical ventilation is necessary if the PaCOj exceeds 6.5 kPa. 

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. 

Total carbon dioxide is used here to describe the quantity that is measured most often in automated analyzers by acidification of a serum or plasma sample and measurement of the carbon dioxide released by the process, or by alkaliniza-tion and measurement of total bicarbonate. Under certain conditions of collection and specimen handling, total carbon dioxide values determined in this manner may be almost identical with values for the calculated concentration of total carbon dioxide obtained in blood gas analysis (see later section in this chapter on blood gas methods). The patho-... 

From Hutchison AS, Ralston SH, Dryburgh FJ, et al. Too much heparin Possible source of error in blood gas analysis, Br Med J 1983 287 1131-2. Significance of difference from percentage volume of 2 p < 0,01 <... 

Adams AP, Hahn CEW, Principles and practice of blood gas analysis. London Franklin Scientific Projects, 1979. 

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 ... 

Mueller RG, Lang GE. Blood gas analysis effects of air bubbles in syringe and delay in estimation. Br Med J Clin Res 1982 285 1659. 

Sodium bicarbonate 1 mEq/kg IV Therapy should be guided by the bicarbonate concentration or calculated base deficit obtained from blood gas analysis or laboratory measurement. Complete correction of the base deficit should be avoided to minimize the risk of iatrogenically induced alkalosis. 

In most cases of acute respiratory acidosis, such as following cardiopulmonary arrest, sodium bicarbonate therapy is not indicated and may be detrimental. Blood gas analysis should guide therapy. 

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