Arterial Blood Gas
Arterial Blood Gas
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动脉血气
DOI：
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发表时间：
2019
期刊：
影响因子：
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通讯作者：
M. Keenaghan
中科院分区：
文献类型：
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作者：
Daniel Castro;M. Keenaghan
血气分析是一种常用的诊断工具，用于评估血液中气体的分压以及酸碱含量。了解和使用血气分析使供应商能够解释呼吸，循环和代谢紊乱。“血气分析”可以对从循环系统中的任何地方（动脉、静脉或毛细血管）获得的血液进行。动脉血气（ABG）专门测试从动脉采集的血液。动脉血气分析评估患者的氧分压（PaO 2），提供关于氧合状态的信息;二氧化碳分压（PaCO 2），提供关于通气状态（慢性或急性呼吸衰竭）的信息，并因过度通气（快速或深呼吸）和通气不足（缓慢或浅呼吸）而改变;以及酸碱状态。虽然氧合和通气可以分别通过脉搏血氧仪和呼气末二氧化碳监测进行无创评估，但血气分析是标准。在评估酸碱平衡时，大多数ABG分析仪直接测量pH和PaCO 2，并通过哈塞尔巴赫方程的导数计算血清碳酸氢盐（HCO 3）和碱缺乏或过量。计算结果经常与测量结果不符;这可能是由于血液中的CO2没有被Henderson-Hasselbach方程所解释。测量的HCO 3使用强碱，释放血清中的所有CO2，包括溶解的CO2，氨基甲酸化合物和碳酸。计算仅考虑溶解的CO2;使用标准化学分析的这种测量可能被称为“总CO2”。因此，差异将达到约1.2 mmol/L。然而，与测量值相比，ABG可能存在较大差异，尤其是在危重患者中。根据所使用的研究、机器或校准，计算结果的准确性和不准确性存在争议，必须根据您的机构标准进行适当解释。动脉血气分析通常由急诊科、重症监护医师、麻醉科和肺病科医生进行，但在其他临床环境中也可能需要。存在使用ABG评估的许多疾病，包括急性呼吸窘迫综合征（ARDS）、严重脓毒症、脓毒性休克、低血容量性休克、糖尿病酮症酸中毒、肾小管酸中毒、急性呼吸衰竭、心力衰竭、心脏骤停、哮喘和先天性代谢缺陷。
Blood gas analysis is a commonly used diagnostic tool to evaluate the partial pressures of gas in blood as well as acid-base content. Understanding and use of blood gas analysis enables providers to interpret respiratory, circulatory and metabolic disorders. A "blood gas analysis" can be performed on blood obtained from anywhere in the circulatory system (artery, vein, or capillary). An arterial blood gas (ABG) specifically tests blood taken from an artery. Arterial blood gas analysis assesses a patient’s partial pressure of oxygen (PaO2), providing information on the oxygenation status; the partial pressure of carbon dioxide (PaCO2), providing information on the ventilation status (chronic or acute respiratory failure, and is changed by hyperventilation (rapid or deep breathing) and hypoventilation (slow or shallow breathing); and acid-base status. Although oxygenation and ventilation can be assessed non-invasively via pulse oximetry and end-tidal carbon dioxide monitoring, respectively, blood gas analysis is the standard. When assessing the acid-base balance, most ABG analyzers measure the pH and PaCo2 directly and through a derivative of the Hasselbach equation calculate the serum bicarbonate (HCO3) and base deficit or excess. The calculation frequently results in a discrepancy from the measured; this may be from CO2 in blood that is not accounted for by the Henderson-Hasselbach equation. The measured HCO3 uses a strong alkali that liberates all CO2 in serum, including dissolved CO2, carbamino compounds, and carbonic acid. The calculation only accounts for dissolved CO2; this measurement using a standard chemistry analysis will likely be called a "total CO2". For that reason, the difference will amount to around 1.2 mmol/L. However, a larger difference may be seen on the ABG, compared to measured value, especially in critically ill patients. The calculation has been disputed as both accurate and inaccurate based on the study, machine or calibration used, and must be interpreted appropriately based on your institutional standards. Arterial blood gases are frequently ordered by emergency medicine, intensivist, anesthesiology and pulmonology physicians, but may also be needed in other clinical settings. There are many diseases that are evaluated using an ABG which include acute respiratory distress syndrome (ARDS), severe sepsis, septic shock, hypovolemic shock, diabetic ketoacidosis, renal tubular acidosis, acute respiratory failure, heart failure, cardiac arrest, asthma and inborn errors of metabolism.