Arterial blood gases (ABG) results reflect underlying pathology and interpretation of the results are often compounded by ongoing disease processes and clinical interventions. While ABG specimens should be analysed immediately for optimal results the Clinical and Laboratory Standards Institute (CLSI) has recommended a window of 30 minutes at room temperature from blood collection to ABG analysis. A fresh and simple approach to interpreting ABG is provided.
MarcoAVVCastilloCMSolerLM. Local anesthesia in arterial puncture: Nurses' knowledge and attitudes. Arch Bronconeumol. 2008;44(7):360–3.
2.
CalafNGinerJCodinaEFeixasTGonzálezMCasanP. Comparison of arterial blood sample kits. Arch Bronconeumol. 2004;40(8):377–80.
3.
NanjiAAWithlowKJ. Is it necessary to transport arterial blood samples on ice for pH and gas analysis?Can Anaesth Soc J. 1984;31(5):568–71.
4.
Clinical and Laboratory Standards Institute. Procedures for the collection of arterial blood specimens; approved standard. 4th edition [Internet]. Wayne, PA, USA: Clinical and Laboratory Standards Institute. 2004 Sep 20 [cited 2011 Oct]. 60 p. Available from: http://www.clsi.org/source/orders/free/H11-a4.pdf.
5.
AARC Clinical Practice Guideline, Sampling for arterial blood gas analysis. Respir Care. 1992;37(8):891–7.
6.
Clinical and Laboratory Standards Institute. Blood gas and pH analysis and related measurements; approved guideline. 2nd edition [Internet]. Wayne, PA, USA: Clinical and Laboratory Standards Institute. 2009 Feb 24 [cited 2011 Oct]. 60 p. Available from: http://www.clsi.org/source/orders/free/c46-a2.pdf.
7.
MelansonSESzymanskiTRogersSOJarolimPFrendlGRawnJD. Utilization of arterial blood gas measurements in a large tertiary care hospital. Am J Clin Pathol. 2007;127(4):604–9.
8.
CallenJGeorgiouALiJWestbrookJI. The safety implications of missed test results for hospitalised patients: A systematic review. BMJ Qual Saf. 2011;20(2):194–9.
9.
LundbergGD. When to panic over abnormal values. MLO Med Lab Obs. 1972;4:47–54.
10.
KostGJ. Critical limits for urgent clinician notification at US medical centers. JAMA. 1990;263(5):704–7.
11.
KostGJ. Critical limits for emergency clinician notification at United States children's hospitals. Pediatrics. 1991;88(3):597–603.
12.
HowanitzPJSteindelSJHeardNV. Laboratory critical values policies and procedures: A College of American Pathologists Q-probes study in 623 institutions. Arch Pathol Lab Med. 2002;126(6):663–9.
13.
JohnsonASchweitzerDAhrensT. Time to throw away your stethoscope? Capnography: Evidence-based patient monitoring technology. J Radiol Nurs. 2011; 30(1):25–34.
14.
GentileNTUfbergJBarnumMMcHughMKarrasD. Guidelines reduce x-ray and blood gas utilizaiton in acute asthma. Am J Emerg Med. 2003;21(6):451–3.
15.
CorboJBijurPLahnMGallagherEJ. Concordance between capnography and arterial blood gas measurements of carbon dioxide in acute asthma. Ann Emerg Med. 2005;46(4):323–7.
16.
HerrejónAInchaurragaIPalopJPonceSPerisRTerradezM. Usefulness of transcutaneous carbon dioxide pressure monitoring to measure blood gases in adults hospitalized for respiratory disease. Arch Bronconeumol. 2006;42(5):225–9.
17.
MorimatsuHRocktäschelJBellomoRUchinoSGoldsmithDGutteridgeG. Comparison of point-of-care versus central laboratory measurement of electrolyte concentrations on calculations of the anion gap and the strong ion difference. Anesthesiology. 2003;98(5):1077–84.
18.
SeveringhausJW. First electrodes for blood PO2 and PCO2 determination. J Appl Physiol. 2004;97(5):1599–600.
19.
SeveringhausJWBradleyAF. Electrodes for blood pH, pO2 and pCO2 determination. J Appl Physiol. 1958;13(3):515–20.
20.
SeveringhausJW. The invention and development of blood gas analysis apparatus. Anesthesiology. 2002;97(1):253–6.
21.
PlebaniM. Does POCT reduce the risk of error in laboratory testing?Clin Chim Acta. 2009;404(1):59–64.
22.
FelderRA. Robotics and automated workstations for rapid response testing. Am J Clin Pathol. 1995;104(4Suppl 1):S26–32.
23.
WinklemanJWWybengaDR. Quantification of medical and operational factors determining central versus satellite laboratory testing of blood gases. Am J Clin Pathol. 1994;102(1):7–10.
24.
PinheiroL. Right-siting of medical care: Role of the internist. Ann Acad Med Singapore. 2009;38(2):163–5.
25.
OtaniNOhdeSMochizukiTIshimatsuS. Reliability of anion gap calculated from data obtained using a blood gas analyzer: Is the probability of error predictable?Am J Emerg Med. 2010;28(5):577–81.
26.
O'SullivanIJeavonsR. Survey of blood gas interpretation. Emerg Med. J.2005;22(5):391–2.
27.
DayJPanditJJ. Analysis of blood gases and acid-base balance. Surg (Oxford). 2011; 29(3):107–11.
28.
LianJX. Interpreting and using the arterial blood gas analysis. Nurs Crit Care. 2010;5(3):26–36.
29.
BaylisCTillC. Interpretation of arterial blood gases. Surg. 2009;27(11):470–4.
30.
NobleKA. The ABCs of arterial blood gasses. J Perianesth Nurs. 2009;24(6):401–5.
31.
SmithATaylorC. Analysis of blood gases and acid-base balance. Surg. 2008;26(3):86–90.
32.
RoweKJArrowsmithJE. Interpretation of measurements of arterial blood gases. Surg. 2007;25(9):375–9.
33.
BrownBEllermanB. Understanding blood gas interpretation. Newborn Infant Nurs Rev. 2006;6(2):57–62.
34.
FletcherSDhrampalA. Acid-base balance and arterial blood gas analysis. Surg (Oxford). 2003;21(3):61–5.
35.
TanSCampbellM. Acid-base physiology and blood gas interpretation in the neonate. Paediatr Child Health. 2007;18(4):172–7.
36.
WilliamsAJ. ABC of oxygen: Assessing and interpreting arterial blood gases and acid-base balance. BMJ. 1998;317(7167):1213–6.
37.
FariaSHTaylorLJ. Interpretation of arterial blood gases by nurses. J Vasc Nurs. 1997;15(4):128–30.
38.
BrouilletteRTWaxmanDH. Evaluation of the newborn's blood gas status. Clin Chem. 1997;43(1):215–21.
39.
TalbotNPSmithTGDoringtonKL. The mechanics and control of ventilation. Surg (Oxford). 2011;29(5):212–6.
40.
HerresJRyanDSalzmanM. Delayed salicylate toxicity with undetectable initial levels after large-dose aspirin ingestion. Am J Emerg Med. 2009;27(9):1173.e1–3.
41.
SuraniSMoralesSRodriguesMVaronJ. The resilience of the human body. Am J Emerg Med. 2011;29(7):835–7.
42.
SaidiHManiM. Severe metabolic acidosis secondary to coadministration of creatinine and metformin, a case report. Am J Emerg Med. 2010;28(3):388.e5–6.
43.
ContouDFichetJGrimaldiDCariouA. Early life-threatening lactic acidosis following a single infusion of linezolid. Int J Antimicro Agents. 2011;38(1):84–5.
44.
BelottiEATaddeoIRagazziMPifferiniRSimonettiGDBianchettiMG. Chronic impact of topiramate on acid-base balance and potassium in childhood. Eur J Paediatr Neurol. 2010;14(5):445–8.
45.
VermeerschNStolteCFostierKDeloozH. An unusual case of hyperglycemia, abdominal pain and increased anion gap acidosis. J Emerg Med. 2010;39(4):449–53.
46.
LeonardJVMorrisAAM. The investigation and initial management of children with suspected metabolic disease presenting acutely. Paediatr Child Health. 2010;21(2):51–5.
47.
MyallKSidneyJMarshA. Mind the gap! An unusual metabolic acidosis. Lancet. 2011;377(9764):526.
48.
ManeATermiziHLamM. A survey of arterial blood gas analysis of older patients. Age Ageing. 2003;32(4):464–5.
49.
LolekhaPHLolekhaS. Value of the anion gap in clinical diagnosis and laboratory evaluation. Clin Chem. 1983;29(2):279–83.
50.
JacobJLavonasEJ. Falsely normal anion gap in severe salicylate poisoning caused by laboratory interference. Ann Emerg Med. 2011;58(3):280–1.
FrancaSAToufenCJrHovnanianALAlbuquerqueALBorgesERPizzoVR. The epidemiology of acute respiratory failure in hospitalized patients: A Brazilian prospective cohort study. J Crit Care. 2011;26(3):330.e1–8.
53.
ThaiyananthanNNJaconoFJ3rdPatelSRKernJAStollerJK. Right-to-left anatomic shunt associated with a persistent left superior vena cava: The importance of injection site in demonstrating the shunt. Chest. 2009;136(2):617–20.
54.
YamakageMKamadaYToriyabeMHonmaYNamikiA. Changes in respiratory pattern and arterial blood gases during sedation with propofol or midazolam in spinal anesthesia. J Clin Anesth. 1999;11(5):375–9.
