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Arteries are the large vessels that carry oxygenated blood away from the heart. The distribution of the systemic
arteries is like a ramified tree, the common trunk of which, formed by the aorta, commences at the left ventricle,
while the smallest ramifications extend to the peripheral parts of the body and the contained organs. For more
information about the relevant anatomy, see Arterial Supply Anatomy.
Arterial blood gas (ABG) testing is used to determine gas exchange levels in the blood related to respiratory,
metabolic, and renal function.
Category
ABG analyzer
Device details
Many ABG analyzers are commercially available. The examples listed below do not represent an all-inclusive list
and are in no specific order.
Abbott - Cell-Dyn 520 hematology analyzer
Roche Diagnostics - AVL Compact 2 blood gas analyzer
Instrumentation Laboratory - IL 682 Co-Oximeter System
Medica - Easy Blood Gas Analyzer
Siemens - 238 Blood Gas Analyzer System
Nova Biomedical - Stat Profile pHOx CO-Oximeter
Design Features
Blood may be drawn from the radial artery or, less commonly, the femoral artery or brachial artery for blood gas
analysis. Once the blood is sampled, visible gas bubbles should be eliminated, since they may dissolve into the
sample and lead to inaccurate results. The sample is then taken to a blood gas analyzer.[1, 2]
See the images below.
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ABG anatomy.
Results are usually available within 5-15 minutes. Aberrant results may result from contamination with room air,
resulting in abnormally low carbon dioxide and near-normal oxygen levels. Delays in analysis of the blood tube
allow for ongoing cellular respiration and may lead to errors with inaccurately low oxygen and high carbon dioxide
levels reported in the results.
The arterial blood gas (ABG) test may determine concentrations of lactate, hemoglobin, electrolytes,
oxyhemoglobin, carboxyhemoglobin, and methemoglobin.
Values at sea level include the following:
Partial pressure of oxygen (PO2) - 75-100 mm Hg
Partial pressure of carbon dioxide (PCO2) - 35-45 mm Hg
Arterial blood pH - 7.38-7.42
Oxygen saturation (SaO2) - 94%-100%
Bicarbonate (HCO3) - 22-26 mEq/L
Indications
Arterial blood gas (ABG) testing is used to determine gas exchange levels in the blood related to respiratory,
metabolic, and renal function. The results may indicate an underlying condition causing acidosis or alkalosis.
Clinical Implementation
During intensive care treatment, sampling and analysis of arterial blood gas (ABG) levels remains the criterion
standard for evaluating sufficient ventilatory support. These results help to determine if the patient is in
metabolic/respiratory alkalosis/acidosis with or without an anion gap.[3, 4] See the Anion Gap calculator.
ABG testing is the criterion standard for determining the adequacy of ventilatory support and the relationship
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Follow-up/Monitoring
Follow-up is as appropriate for patient monitoring and disease progression.
Complications
Bleeding, blood flow problems, and/or delayed bleeding at the puncture site
Bruising
Pain
Feeling light-headed or fainting
Hematoma
Infection
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for Clinical Vascular Surgery, Society for Vascular Surgery, and Western Vascular Surgical Society
Disclosure: Nothing to disclose.
References
1. Kirmizis D, Kougioumtzidou O, Vakianis P. Diagnostic accuracy of arterial line blood gas measurements
as an estimate of arteriovenous fistula recirculation. Nephrology (Carlton). Jul 1 2013;[Medline].
2. Budak YU, Huysal K, Polat M. Use of a blood gas analyzer and a laboratory autoanalyzer in routine
practice to measure electrolytes in intensive care unit patients. BMC Anesthesiol. Aug 3 2012;12:17.
[Medline]. [Full Text].
3. Baillie JK. Simple, easily memorised "rules of thumb" for the rapid assessment of physiological
compensation for respiratory acid-base disorders. Thorax. Mar 2008;63(3):289-90. [Medline].
4. Dzierba AL, Abraham P. A practical approach to understanding Acid-base abnormalities in critical illness.
J Pharm Pract. Feb 2011;24(1):17-26. [Medline].
5. Sagy M, Barzilay Z, Boichis H. The diagnosis and management of acid-base imbalance. Pediatr Emerg
Care. Dec 1988;4(4):259-65. [Medline].
Medscape Reference 2011 WebMD, LLC
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