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2.6 - Obtaining and Interpretation of Results from Blood Gas Samples (Acid–Base Balance and Disorders)
from Section 2 - Diagnosis, Assessment, Investigation, Monitoring and Data Interpretation
- By Ed McIlroy
Edited by Ned Gilbert-Kawai, The Royal Liverpool Hospital, Debashish Dutta, Princess Alexandra Hospital NHS Trust, Harlow, Carl Waldmann, Royal Berkshire Hospital, Reading
Book:

Intensive Care Medicine

Published online:

27 July 2023

Print publication:

01 December 2021, pp 37-42
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Summary

Key Learning Points
1. Whilst the radial artery is a common sample site, 24–27 per cent of patients will have a negative modified Allen’s test (no/minimal ulnar supply).
2. Remember to expel air and heparin from the syringe to avoid sample contamination.
3. Errors can be associated with sample collection, machine processing and interpretation.
4. Metabolic acidosis can be high anion gap (MUDPILES) or normal anion gap (PANDA RUSH).
5. Stewart’s approach to acid–base disturbance considers the strong ion difference (SID), total weak acid concentration (Atot) and partial pressure of carbon dioxide (PaCO2).