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PH, Paco2 Hco3-: Usefulness

This document presents a simple 4-step method for analyzing arterial blood gases (ABGs) to determine acid-base balance. It considers just 3 values: pH, PaCO2, and HCO3-. Step 1 uses pH to identify acidosis or alkalosis. Step 2 uses PaCO2 to determine the respiratory effect. Step 3 assumes the metabolic cause when respiratory is ruled out. Step 4 uses HCO3- to verify the metabolic effect. This method is useful for the majority of ABG cases but does not account for complete compensation or instances of combined respiratory and metabolic imbalance, which are rarer.

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129 views1 page

PH, Paco2 Hco3-: Usefulness

This document presents a simple 4-step method for analyzing arterial blood gases (ABGs) to determine acid-base balance. It considers just 3 values: pH, PaCO2, and HCO3-. Step 1 uses pH to identify acidosis or alkalosis. Step 2 uses PaCO2 to determine the respiratory effect. Step 3 assumes the metabolic cause when respiratory is ruled out. Step 4 uses HCO3- to verify the metabolic effect. This method is useful for the majority of ABG cases but does not account for complete compensation or instances of combined respiratory and metabolic imbalance, which are rarer.

Uploaded by

brfactor
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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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 toward  Normal   Tends toward


alkalosis acidosis
 Causes high pH  Causes low pH
 Neutralizes low or  Neutralizes high
pH pH
Compensated

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 PaCO2 Low PaCO2 High PaCO2 Low 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.

Step 4. Use HC03 to verify metabolic effectNormal

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).

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