Arterial Blood Gases Made Easy - I. Hennessey, A. Japp (Churchill Livingstone, 2007) WW

143 Pages·2007·13.16 MB·English

lain A M Hennessey MBCha (Ho,n)'" IH='I M'eS
Senior House Officer, Ne()nol<lllnlens;lIe Core
Royol United HosPIIaI, Bath, UK

Alan G Japp MIlCh. iHoNl SS< IHomI MlCP

Clinical Research Fellow in Cordiology
University 01 Edinburgh, UK

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Preface

If you've taken the time to open Arfnwl Blood Gases Mnd, l-:tJsy, you
must believe that artenal blood gases (AHtJi) are unportant. but not
Pntirely:,lraightforward.

We ft>rtamly agn..~ on the first pomt: ABC analysis now play:. il/1
indispensablf' role in the assessment and manilKcmcnt of pahf'nh;
wltll a huge range of acute moollal and surgu"al problems. AccuratE'
ABG interpretation is undoubtedly a fundamental skill U1 modem
clink'" medianl::.

On the SI.'('ond pomt, we hope this book ran bto of a~sislance.
Throughout. our aim~ have ~,\ to emphasi<:l' the key concept~,
fnrus on priKtical and useful aspects ofABG analysi!! and dvoid
extrant"Ous detal1. \Vc believe lThlny medical and nursing students,
JWlior doctors and specmhst nurses will benefit from a dear, roncise
guide to performing thl? te<:hnl4uc and interpN>tmg the results

lain A M HeJUlCSSCY
Alan Glapp

•

Contents

Prefcx:e
v

Acknowledgements
V"

Port 1 The ABG explained
1

1.1
Introduction
3
1.2
Pulmonary gas excnange: the basics
4
1.3
Disorders of gas exchange
18
1.4
Acid-bose balance: the basics
26
•
1.5
Disorders of ocid--bo$e balance
36
1 6
ABG $Ompliog technique
42
1.7
When and why IS on ABG required?
48
1.8
Common values
50
19
Making ABG inlefprctolion easy
52

Appendix
56

Pori 2 The ABG in practice
57

Cases 1-25
58

Answers
109

l<>de.
135

1. 1
..
INTRODUCTION

Arterial blOOl"l ~,\S (ABC) analysis ~fers 10 the mcasuremE'nt of pi I
and the partial pn:s~.m:s of oxygen (Oz) and carbon dioxide (Co,) in
artt>rial blood. From these values we can ass....s ttwo state oftJdJ--buse
bolanCt in blood and how well lungs are ~riormingtheir job of gll5

,:xc}Ul11gt.

Already the~ afC questions: what is meant by 'acid-base status'?
What is.:l 'partial pressure'? Why do they matter? It helps to break
things cJown.

Part 1 of this book is designed to answer the:;e questions. We start
with a few p<lg~ covering the b.1sic CSSli:Jlhals of respiratory and aad
base physIology: plel1St' do not skip them! If you understand these