The maintenance of normal blood pH depends crucially on synergy of action between lungs and kidneys, so that students of acid-base physiology must become familiar with the interrelatedness of kidney and lung function in both health and disease.  This interrelatedness is the central theme of a recently published review ...

Reprinted with permission from British Journal of Nursing, 2004, Vol 13, No 9.  Arterial puncture is the most common method used to obtain a sample for the measurement of arterial blood gases (ABGs) and is essential to guide the prescription of long-term oxygen therapy (LTOT) in patients with chronic hypoxic lung...

In Geneva in 1821, a French nobleman Jacques Alexandre Le Jumeau, Vicomte de Kergaradec, became the pioneer of modern fetal monitoring. He described the sound of the fetal heartbeat, as he used the newly invented stethoscope (by Laennec, France 1819) and applied it to the abdominal wall of a pregnant woman [1]. The...

One of the principal clinical uses of blood gas analysis is assessment of patient acid-base status, but over the years controversy has dogged understanding of the principles of acid-base physiology and interpretation of blood gas results.  In a brief review of the history of clinical acid-base balance, the author...

A recently published paper describes the sad case history of a 17-year-old man who was brought, unconscious and totally unresponsive (Glasgow Coma Score 3), by ambulance to the emergency department of his local hospital. Blood gas analysis revealed he was suffering severe metabolic acidosis (pH 7.25, bicarbonate 9...

Measurement of blood lactate provides clinicians with a valuable means of identifying and monitoring critically ill patients who are suffering clinical shock as a result of severe trauma, sepsis or cardiogenic shock. Lactic acid accumulates in the blood of these patients due to the tissue hypoxia that results from...

Until 1978, the year of the first oxygenless ascent of Mount Everest, it had been assumed that it was impossible to survive at the summit of Mount Everest (altitude 8800 m) without supplemental oxygen. At this high altitude, pO2 of inspired air is around 50 mmHg, a third of the oxygen content of air at sea level....

This is the second of two articles about the risks and benefits of red-cell transfusion directed at healthcare professionals without any particular transfusion expertise. The focus of the first article was the risks and the extensive measures taken to minimize those risks. For this second article, attention turns to...

The standard sample for measurement of blood gases is arterial blood. Arterial puncture is painful and, because of inherent dangers, is usually only performed by qualified medical staff. Arterialized earlobe capillary blood sampling provides a less painful and safer alternative, which can be reliably performed after...

When blood gas analysis reveals a reduced pO₂(a) in a patient without any immediate clinical evidence of hypoxemia, consideration should be given to the possibility that the result is falsely low, allowing a diagnosis of spurious or pseudo-hypoxemia.  Technical deficiencies (e.g. sampling of venous rather than...