Blood Gas (ABG) Interpretation and Acid-Base Pathology 1- Does the patient have an acidosis or an alkalosis? Look at the pH 2- What is the primary problem – metabolic or respiratory? Look at the pCO2 Think ROME = Respiratory Opposite, Metabolic Equal (If pCO2 change is in the opposite direction of the pH change, the primary problem is respiratory) 3- Is there any compensation by the patient? Do the calculations. For a primary respiratory problem, is the pH change completely accounted for by the change in pCO2 if yes, then there is no metabolic compensation if not, then there is either partial compensation or concomitant metabolic problem For a metabolic problem, calculate the expected pCO2 if equal to calculated, then there is appropriate respiratory compensation if higher than calculated, there is concomitant respiratory acidosis if lower than calculated, there is concomitant respiratory alkalosis **If it is a metabolic acidosis, you need to do more work = ANION GAP - Amy Chung, MD, MSc @AmyChung #AcidBase #ABG #Interpretation #BloodGas #Respiratory #Metabolic #Acidosis #Alkalosis #Diagnosis