Case scenario of ABG Anaysis concerning on pH, acidosis, alkalosis, anion gap and systematic approach to the case

1. INTERPRETATION OF ARTERIAL
BLOOD GAS ANALYSIS &
MAJOR ELECTROLYTES
Prepared by: Anish Dhakal (Aryan)
MBBS Student
Patan Academy of Health Sciences

2. OBJECTIVES
• To interpret the ABG and electrolyte abnormality

3. CASE SCENARIO
• Mr.Bibesh Kafle (5 yrs.) brought to PH emergency with CC
rice watery diarrhea for more than ten times for last three
days, even thirsty drink little amount of water due to multiple
episode of vomiting, passed very little amount of urine in
last 24 hrs
• On physical examination he was unwell lethargic, poorly
responsive with lack of muscle tone.
• He was started on an I.V fluid resuscitation.
• Doctor asked for RFT, stool and routine urine examination

4. ABG ANALYSIS: BASIC CONCEPTS
• Three Question Method:
1) What is the osis?
2) What is the cause of the osis?
3) Was there compensation?

8. ABG REPORT
1st Report 2nd Report
pH 7.10 7.26
pCO2 20 mmHg 26 mmHg
HCO3 6 mmol/L 12 mmol/L
Predicted pCO2 17±2 mmHg 26±2 mmHg

9. ANION GAP

10. ELECTROLYTE REPORT
1st Report Normal values 2nd Report
BUN (mg/dL) 55 5 - 20 78
Serum creatinine
(mg/dL)
2.4 0.4 - 1.2 4.5
Serum [Na+]
mEq/L
136 135 – 145 128
Serum [K+]
mEq/L
2.9 3.5 – 5.0 6.2

11. DECREASED SODIUM
fluid therapy
decreased re-absorption of
Na+ due to necrotic tubules

12. ELEVATED POTASSIUM
• decreased secretion
of K+ due to necrosis
• acidosis