Introduction: Arterial blood gas (ABG) analysis plays an important role in the treatment of intensive care patients, especially for critically ill patients but are often difficult to understand, interpret, and sometimes confusing if both the metabolic and respiratory disturbances are found. There are only few graphical tools available depicting the respiratory and metabolic acid–base disturbances but are rarely used in clinical setting.
Aim: The aim of the current research study is to develop a newer graphical tool for ABG interpretation.
Materials and methods: A total of 120 arterial blood samples were collected and analyzed using ABG analyzer. The ABG parameters like pH, pCO2, HCO3, and standard HCO3 values were noted. Standard base excess was calculated from the obtained data. Arterial blood gas interpretation was done and all the 120 samples were classified into various acid–base disorders. The difference in value between bicarbonate and standard bicarbonate (HCO3 – standard HCO3) was calculated. Carbonic acid was derived from pCO2 values and the ratio (HCO3 – standard HCO3)/H2CO3 was found. The relationship between pCO2, difference between bicarbonate and standard bicarbonate values, and the ratio (HCO3 – standard HCO3)/H2CO3 were graphically analyzed. A novel four-quadrant graph method was developed using standard base excess in the x-axis and the ratio (HCO3 – standard HCO3)/H2CO3 values in the y-axis.
Results: Each acid–base disorders will occupy any of the four quadrants and the normal cases with no acid–base disturbances will be seen around the center of the graph.
Conclusion: This newer graphical tool may help in easier and quicker interpretation of ABG reports compared with the other existing graphical tools.
Clinical significance: This simple four-quadrant graph method may provide a rough guide for ABG interpretation, which, when applied at the appropriate time, results in timely management.
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