ICU Vivas · Acid–base
Equipment viva — the blood-gas analyser and what it measures
An equipment viva on the modern blood-gas analyser — its measuring electrodes and CO-oximetry, the distinction between the measured values (pH, PaCO2, PaO2, electrolytes, lactate, glucose, haemoglobin and its derivatives) and the derived values (bicarbonate, base excess, anion gap, oxygen saturation), the sources of error, and the arterial-versus-venous and pre-analytical pitfalls.
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Overview of the device
The modern point-of-care blood-gas analyser is a benchtop device that reports a full acid–base, oxygenation, electrolyte and metabolic panel from a single small (arterial or venous) sample within about a minute. Its usefulness in the intensive care unit lies in the speed and the small sample volume, which make it the workhorse of bedside acid–base and respiratory monitoring.[2]
References3ShowHide
- [1]Kraut JA, Madias NE. Serum Anion Gap: Its Uses and Limitations in Clinical Medicine. Clinical Journal of the American Society of Nephrology, 2007.PMID 17699401
- [2]Bersten AD, Soni N (eds) Oh's Intensive Care Manual. 8th edition, Elsevier, 2018.
- [3]Marino PL The ICU Book. 4th edition, Lippincott Williams & Wilkins, 2014.