Kirjahaku

Arterial blood gas analysis is sometimes confusing, often challenging and also an arduous task. The actual bicarbonate and the standard bicarbonate concentrations differ under abnormal ventilation, the two values alter and deviate from each other depending on the changes in the concentration of pCO2. A novel four quadrant graphical tool was developed by the current author based on this concept for ABG interpretation using standard base excess and the ratios derived using standard bicarbonate, bicarbonate and carbonic acid that demarcates the various acid base disturbances. The physicochemical approach gives mechanistic explanation for the causes of metabolic acid-base disturbances, but it cannot completely replace the physiological or traditional approach. Therefore understanding the relationship between these three approaches is very essential. A novel ABG interpretation method was developed based on the first postulate of acid base balance theory correlating the net changes in total or actual pH with the changes in respiratory and non-respiratory (metabolic) component affecting the pH.

The interpretation of arterial blood gas (ABG) analysis is done by various approaches each having its own advantages and disadvantages and it is a challenging task, especially in cases of mixed acid base disorders and multi organ failure patients. Understanding the interrelationship of the various acid base approaches plays a vital role to overcome this arduous task. The current project discusses the various acid base approaches, concept of non respiratory hydrogen ion concentration and its relationship with other approaches, the summary of the acid base balance theory and suggested a novel arterial blood gas interpretation method.