Interpretasi hasil

Analisa Gas Darah

(formula Anderson-Hasselbach)

ICU 2016
 Empat tipe gangguan dasar asam-
basa

 Asidosis respiratori
 Alkalosis respiratori
 Asidosis metabolik
 Alkalosis metabolik
 Assessing ABGs

 pH 7.35 - 7.45
 PaCO2 35 - 45 mmHg
 HCO3 22 - 26 mEq/L
 Base Excess -2 - +2 mEq/L
 PaO2 80 - 100 mm Hg
 O2 saturation 95 - 100 %
 Interpretasi ABGs

1. Dimulai dari nilai pH

 Normal?
 Acidosis?
 Alkalosis?

___/______/___/______/___
6.8 7.35 7.45 8.0
Acidosis
Alkalosis
2. penilaian PaCO2
(nilai untuk respirasi)

_____/________/______
35 45
Respiratory Respiratory
Alkalosis Acidosis
3. Evaluasi indikator metabolik

 Bicarbonate (HCO3) 22-26

&
 Base excess (-2 to +2)
 HCO3

_______/_______/________
22 26

 BE
______/_______/_________
-2 +2
Metabolic Metabolic
acidosis alkalosis
4. Tetapkan level kompensasi yang
terjadi
 Tidak terkompensasi
 Terkompensasi sebagian
 Kompensasi penuh
 Tidak terkompensasi
 pH abnormal (tinggi atau rendah)
 Satu komponen abnormal (tinggi
atau rendah pada CO2 atau HCO3)
 Komponen lainnya normal

 (The component not causing the

acid-base imbalance is still
normal)
Partly compensated

 pH not normal (but moving toward

normal)
 Both CO2 and HCO3 are outside
normal range
 The component that was normal is
changing in order to compensate
Compensated

 pH normal
 Other values abnormal in opposite
directions
 One is acidotic the other alkaline
 Determine amount of hypoxemia
present
 Normal PaO2 (adults - room air)
 < 70 years = 80-100 mm Hg
 70-79 = 70-100 mm Hg
 Drops 10 mm Hg for each decade
 Hypoxemia = < 70 mm Hg
(for adult < 70 years old)
 Mild = 60-80 mm Hg
 Moderate = 40-60 mm Hg
 Severe = < 40 mm Hg
Oxygen saturation (pulse oximetry)
 95-100%
 < 91% confusion
 < 70% life threatening
80 year old female with severe
pneumonia, fever
 pH = 7.25
 PaCO2 = 55 mm Hg
 HCO3 = 24 mEq/L
 PaO2 = 65 mm Hg
 O2 sat = 80%
Masalah yang dihadapi pasien?
 Acidosis or alkalosis?
 Respiratory or metabolic?
 Compensated or not?
 Level of hypoxemia?
 Case 1

ABG: pH 7.25
PCO2 60
HCO3- 26
PO2 55
 Case 2

ABG: pH 7.35
PCO2 34
HCO3- 18
PO2 92

Urine pH: 5.0

 Case 3

ABG: pH 7.49
PCO2 28
HCO3- 21
PO2 52
 Case 4

ABG: pH 7.47
PCO2 46
HCO3- 32
PO2 96

Urine pH: 5.8

 Case 5

ABG: pH 7.12
PCO2 50
HCO3- 13
PO2 52

Urine pH: 5.0

 Case 6

ABG: pH 7.15
PCO2 30
HCO3- 10
PO2 88

Urine pH: 5.0

 Case 7

ABG: pH 7.21
PCO2 85
HCO3- 33
PO2 47

Urine pH 5.5
 Case 8

ABG: pH 7.03
PCO2 75
HCO3- 19
PO2 48

Urine pH 5.0
 kasus

A B C D E F
pH 7.27 7.25 7.52 7.53 7.26 7.48

pCO2 60 40 25 41 22 21

HCO3 20 16 22 31 10 13

BE +2 -10 -2 +8 -15 -8
 Soal 2a

Hasil ABGs pasien KAD =

PaCO2 = 52,6
PaO2 = 60,5
FiO2 saat pengambilan AGD = 60%
 Soal 2b

Hasil ABGs pasien KAD =

PaCO2 = 60,5
PaO2 = 76.4
FiO2 saat pengambilan AGD = 75%