For simplicity reasons I will only refer

to the three basic ABG values in this

post: pH (acid base balance), CO2
(carbon dioxide) and HcO3
(bicarbonate).

Normal ABG values are as

follows
pH (acid base balance) = 7.35 to 7.45
CO2 (carbon dioxide) = 35 to 45
HcO3 (bicarbonate) = 22 to 26

CO2 greater than 45 is acidotic

HcO3 less than 22 is acidotic
Co2 less than 35 is alkalotic
HcO3 greater than 26 is alkalotic

Lets interpret
Is the ABG normal?
If all of them are, then you have a
normal ABG and you can stop here. If
any one of the values is out of the
normal range, then you must move
on to the next question.

Is the pH Acidotic or
Alkalotic?
To determine this you look only at the
pH.
Alkalotic: If the pH is greater than
7.45 the patient is Alkalotic.
Acidotic: If the pH is below 7.35 the
patient is acidotic.

Is the cause respiratory or

metabolic?
To determine this, you look at pH and
compare it with HcO3 and CO2.
If the pH is acidotic, you look for whichever
value (HcO3 or CO2) that is also acidotic. If
the pH is alkalotic, you look for whichever
value (HcO3 or CO2) is also alkalotic.
In this sense, you match the pH with HcO3
and CO2. If the pH matches with the CO2,
you have respiratory. If the pH matches
with the HcO3, you have metabolic.

Or, put more simply..

Metabolic Alkalosis: If the pH is alkatotic
and the HcO3 alkalotic.
Respiratory Alkalosis: If the pH is
alkalotic and the CO2 is alkalotic
Metabolic Acidosis: If the pH is acidotic
and the HcO3 acidotic.
Respiratory Acidisis: If the pH is acidotic
and the CO2 is acidotic.

Is the cause compensated or

uncompensated?
Uncompensated: if the pH is
anywhere outside the normal ranges
(greater than 7.45 or less than 7.35)
Compensated: pH is anywhere inside
the normal ranges (Anything
between 7.35 to 7.45)

some examples
1. Ph 7.40, CO2 37, HcO3 23
What do you have here? All the
number are within normal range, so
you have a normal ABG.

2. ph 7.23, CO2 50, HcO3 22

What do you have here?
A. Is the ABG normal? You can see right away that the pH and CO2 are out of
the normal range, so you must move on to the next question.
B. Is the pH acidotic or alkalotic? Since the pH is less than 7.35 it is acidotic.
C. Is is metabolic or respiratory? Since the pH is acidotic and the CO2 also
acidotic, then you have respiratory acidosis.
D. Is it compensated or uncompensated? Well, the pH is outside the normal
range of 7.35 to 7.45, so it is uncompensated. You don't have to look at any
other values. You are done.
The ABG is uncompensated respiratory acidosis

 pH 7.36, CO2 50, HcO3 29,

A. Is the ABG normal? You can see right away that both CO2 and HcO3
are out of the normal range, so you move on to the next question.
B. Is is acidotic or alkalotic: The pH is less than 7.39, so it is acidotic
C. Is the cause respiratory or metabolic?: The pH is acidotic and the
CO2 is also acidotic, so you have respiratory acidosis.
D. Is it compensated or uncompensated? Since the pH is within normal
limits, it is compensated.
In this example you have compensated respiratory acidosis.

 pH 7.50, CO2 42, HcO3 33

A. Is the ABG normal? No. Some of the values are outside the normal
ranges.
B. Is it acidotic or alkalotic? The pH is greater than 7.41, so it is alkalotic.
C. Is the cause respiratory or metabolic?: You know the pH is alkalotic, so
you look for the matching value. The HcO3 is alkalotic, so it matches the
pH. So, what you have is a metabolic problem.
D. Is it compensated or uncompensated? Since the pH is outside the
normal range of 7.35 to 7.45, it is uncompensated.
Thus, you have uncompensated metabolic alkalosis.

 pH 7.50, CO2 18, HcO3 24

A. Is the ABG normal? No, pH and CO2 are both out of the normal
range.
B. Is it acidosis or alkalosis? Since the pH is greater than 7.45 it is
alkalosis
C. Is is respiratory or metabolic? Since the pH is alkalotic and the CO2
is also alkalotic, you have a respiratory problem
D. Is is compensated or uncompensated: It is uncompensated because
the pH is outside the normal range of 7.35 to 7.45.
What you have here is uncompensated respiratory alkalosis.