ABG Analysis ÍÍÍÍÍÍÍÍÍÍÍÍ ÉÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍ» º Check the pH on the ABG to tell whether the patient has an Acidemia º º (pH) or Alkalemia (pH) or EupHemia (normal pH). º ÌÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍ͹ º Check the bicarb on the SMA-6* and the pCO2 on the ABG. pH with º º [HCO3-], or pH with [HCO3-], indicates a primary metabolic acidosis º º or alkalosis; pH with pCO2, or pH with pCO2, indicates a primary º º resp. acidosis or alkalosis. º ÌÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍ͹ º Check for the expected degree of compensation. .** º ÌÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍ͹ º For metabolic acidosis, check to see if it is an anion gap acidosis, a º º non-anion gap acidosis, or a mixed disorder. If all of the acidosis º º is due to anion-gap acids, then the increase in the anion gap should º º be the same as the decrease in the [HCO3-]. E.g., if the A.G. is 20 º º (normal 12), and the [HCO3-] is 19 (normal 27), then all of the º º acidosis (all of the [HCO3-]) is due to the A.G. from excess organic º º acids that form the anion gap. º ÈÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍͼ ----- *Note that SMA-6 autoanalyzer may not accurately determine very high HCO3-, so the [HCO3-] must be done manually by the lab. **None but respiratory alkalosis can have compensation all the way back to a normal pH. A normal pH with any other disorder indicates a second, superimposed, acid-base disorder.