‫جامعة دار السالم للعلوم والتكنولوجيا‬

‫‪Prepared by:‬‬
‫‪Dr. Mohammed Al-olofi‬‬

‫‪8/7/2023‬‬ ‫‪1‬‬
➢ Blood gas analysis, also called arterial blood gas (ABG) analysis, is
a test which measures the following:
✓ The amount of oxygen
✓ The amount of carbon dioxide in the blood,
✓ The acidity (pH) of the blood.
✓ Other parameters.

➢ Blood gas analysis evaluates;

✓ how effectively the lungs are delivering oxygen to the blood and how
efficiently they are eliminating carbon dioxide from it.
✓ how well the lungs and kidneys are interacting to maintain normal
blood pH (acid-base balance).
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➢ Blood Gas Analyzer Measure the following Parameters:
✓ pH Acid Degree Measure
directly
✓ PO2 Partial pressure of oxygen in blood from the
patient
✓ PCO2 Partial pressure of carbon dioxide in blood
sample
✓ HCO3- Bicarbonate
✓ Total CO2
✓ BB Buffer base
✓ BE base excess
✓ BEecf base excess extracellular fluid
✓ SO2 percent O2 saturation
✓ ctCO2 total CO2 concentration
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➢ Blood gas analyzer is used in:
1) respiratory therapy departments,
2) clinical and cardiopulmonary laboratories,
3) critical care units,
4) surgical suites,
5) physician offices,
6) and hospital nurseries.
➢ During respiration, there is an exchange of O2 and CO2 between the pulmonary
capillaries and the alveoli in the lungs.
➢ O2 enters the bloodstream and is bound to and transported by the hemoglobin
in red blood cells; a small amount of O2 dissolves in the plasma.
➢ CO2, a waste product of metabolism, is transported back to the lungs in
combination with water in the form of bicarbonate , dissolved in plasma, or
joined with the amino groups on the hemoglobin molecule.

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➢ pO2 is the measurement of the O2 concentration in blood.
➢ Checks how well the patient is “taking up” oxygen
➢ Normal pO2 ( 80 to 90 mmHg)
➢ Testing pO2 is actually measuring how much oxygen the lungs are
delivering to the blood.
➢ pCO2 is the measurement of the CO2 concentration in blood
➢ Normal pCO2 (35 to 45 mmHg)
➢ pCO2 pressure indicates how well the lungs are eliminating carbon dioxide.
➢ pH is the measurement of acidic level of the blood and is defined
as the negative log of the hydrogen ion concentration.
PH = - log (H+)
➢ A pH of 7 is considered neutral (pure water).
➢ A pH less than 7 is acidic with 1 being the most acidic.
➢ A pH greater than 7 is basic with 14 being the most basic.
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➢ Normal blood pH is (7.35 - 7.45)
 state pH
Normal 7.35 - 7.45

Acidosis < 7.35

Alkalosis >7.45

State PO2 (mm Hg) State PCO2 (mm Hg)

Normal 80 -100 Normal 35 -45

Hypoxemia < 80 hypocapnia < 35

Hyperoxemia >120 hypercapnia >45

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➢ Now since we’re measuring gas pressures we have to correct for
some environmental variables that have an effect on gas pressure
➢ Patient sample temperature: so the analyzers maintain the patient
sample at 37oC.
➢ Barometric pressure: so the Blood Gas Analyzer continuously monitors
barometric pressure and electronically corrects for it.
➢ The water vapor pressure of our calibration gases: we need to
make water vapor pressure a known value (or a constant) when we calibrate
the analyzer.
➢ The calibration gases are saturated with water vapor by running them
through a humidifier prior to the gases being measured.
➢ Water saturated gas has a water vapor pressure of 47 mmHg (at 37°C).
➢ If our water vapor saturated gas produces a total pressure of 760 mmHg,
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then a dry gas would have a pressure of 760 - 47 = 713 mm Hg.
 High O2 Microprocessor
Low CO2
Calibrator
Gas Low O2 Display/Printer
High CO2

Water bath
Standard High pH 37oC
PO2 pH
Buffers Low pH
E1 E3 Pump

V Chamber

E2 E4
Sample w
Probe PCO2 Reference for pH
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➢ All blood gas analyzers have the following components:
✓ Electrode Module
✓ Reagent module
✓ Humidifier Wells
✓ Sample Input Port
✓ Peristaltic Pump
✓ Waste Module

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➢ Electrode Modules
1) pH Electrode
✓ Output varies with the pH level of the sample being analyzed.
2) pCO2 Electrode
✓ Produces a voltage proportional to the pCO2 content of the sample.
3) pO2 Electrode
✓ Produces a voltage proportional to the pO2 content of the sample.
4) Reference Electrode
✓ Supplies a constant, unchanging electrical potential (756 mV) that is
used as a reference to measure the electrical potential produced by each
measuring electrode.

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➢ Electrode Modules
❖ pO2 Electrode

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➢ Electrode Modules
❖ pO2 Electrode
✓ The PO2 electrode basically consists of two terminals
1) The cathode, which usually made of platinum (negatively
charged)
2) The anode, which usually made of silver– sliver chloride
(positively charged).
✓ the electricity source (battery or wall electricity) supplies the
platinum cathode with energy (voltage of 700 mV).
✓ This voltage attracts oxygen molecules to the cathode surface,
where they react with water.
✓ This reaction consumes four electrons for every oxygen molecule
reacts with water and produces four hydroxyl ions.
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➢ Electrode Modules
❖ pO2 Electrode
✓ The consumed four electrons, in turn, are replaced rapidly in the
electrolyte solution as silver and chloride react at the anode.
✓ This continuous reaction leads to continuous flow of electrons
from the anode to the cathode (electrical current).
✓ This electrical current is measured by using an ammeter (electrical
current flow meter). Or
✓ The current generated is in direct proportion to the amount of
dissolved oxygen in the blood sample, which in direct proportion
to PO2 in that sample.

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➢ Electrode Modules
❖ pO2 Electrode

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➢ Electrode Modules
❖ pO2 Electrode

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➢ Electrode Modules
❖ pO2 Electrode

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➢ Electrode Modules
❖ pO2 Electrode

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➢ Electrode Modules
❖ pH Electrode

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➢ Electrode Modules
❖ pH Electrode
✓ The pH electrode uses voltage to measure pH,
✓ rather than actual current as in PO2 electrode. It compares a
voltage created through the blood sample (with unknown pH) to
known reference voltage (in a solution with known pH).
✓ To make this possible, the pH electrode basically needs four
electrode terminals, rather than two terminals (as in the PO2
electrode).

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➢ Electrode Modules
❖ pH Electrode
✓ Practically, one common pH-sensitive glass electrode terminal
between the two solutions is adequate.
✓ This glass terminal allows the hydrogen ions to diffuse into it from
each side.
✓ The difference in the hydrogen ions concentration across this glass
terminal creates a net electrical potential (voltage).
✓ A specific equation is used to calculate the blood sample pH, using
the reference fluid pH, the created voltage, and the fluid
temperature.

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➢ Electrode Modules
❖ pH Electrode
✓ A specific equation is used to calculate the blood sample pH, using
the reference fluid pH, the created voltage, and the fluid
temperature.

E = Eo – (2.3036*RT/F)*dpH
✓ R = gas constant
✓ T = temp.
✓ F = faraday constant

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➢ Electrode Modules
❖ pH Electrode

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➢ Electrode Modules
❖ pH Electrode

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➢ Electrode Modules
❖ pH Electrode

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➢ Electrode Modules
❖ pH Electrode

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➢ Electrode Modules
❖ pCO2 Electrode

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➢ Electrode Modules
❖ pCO2 Electrode
✓ The PCO2 electrode is a modified pH electrode. There are two
major differences between this electrode and the pH electrode.
✓ The first difference is that in this electrode, the blood sample
comes in contact with a CO2 permeable membrane (such as Teflon,
Silicone rubber), rather than a pH-sensitive glass (in the pH
electrode).
✓ The CO2 from the blood sample diffuses via the CO2 permeable
(silicone) membrane into a bicarbonate solution.
✓ The amount of the hydrogen ions produced by the hydrolysis
process in the bicarbonate solution is proportional to the amount

8/7/2023
of the CO2 diffused through the silicone membrane. 28
➢ Electrode Modules
❖ pCO2 Electrode
✓ The amount of the hydrogen ions produced by the hydrolysis
process in the bicarbonate solution is proportional to the amount
of the CO2 diffused through the silicone membrane.
✓ The difference in the hydrogen ions concentration across the pH-
sensitive glass terminal creates a voltage.
✓ The measured voltage (by voltmeter) can be converted to PCO2
units. The other difference is that the CO2 electrode has two
similar electrode terminals (silver–silver chloride).
✓ However, the pH electrode has two different electrode terminals
(silver–silver chloride and mercury–mercurous chloride).

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➢ Electrode Modules
❖ pCO2 Electrode

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➢ Electrode Modules
❖ pCO2 Electrode

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➢ Electrode Modules
❖ pCO2 Electrode

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➢ Electrode Modules
❖ pCO2 Electrode

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➢ Heater:
➢ Maintains the electrode module at 37 degrees Celcius.

➢ Temperature Sensor:
➢ Monitors the temperature of the Electrode Module and indicates when the
temperature is more than 2 degrees below (or above) 37.

➢ Air/Fluid Detector:
➢ Located at the entrance or exit of the Electrode Module.
➢ Verifies the presence of air or fluid in the sample tubing.
➢ A small light source shines through the tubing into a photodetector.
➢ The photodetector is monitored by the μP which monitors the air/fluid
detector so it knows when to start and stop the peristaltic pump.
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➢ The reagent module:
➢ houses the two solutions used to calibrate the pH electrode and the wash
solution.
➢ There are two liquid solutions used to calibrate the pH electrode during a 2
point calibration (more on 2 pt calibrations later).
➢ The Cal solution has a pH level of 7.382
➢ The Slope solution has a pH level of 6.838
➢ The Wash solution is used to wash the patient sample out of the analyzer
after analysis.

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➢ The humidifier wells:
➢ are used to saturate the gases used to calibrate the pO2 and pCO2
electrodes with water for the reason we talked about earlier.
➢ As the calibration gases (Cal gas and slope gas for 2 point calibration) enter
the analyzer from their pressurized tanks, the first component they come to
is the humidifier well.
➢ The humidifier well is a well with humidifier solution in it (deionized water)
that the gas bubbles through on it’s way to the electrode module for
measurement by the pO2 and pCO2 electrodes.

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➢ The Sample Input Port:
➢ is where the patient sample is entered into the analyzer.
➢ The patient sample is usually entered into the analyzer using the same
syringe that was used to draw the blood sample with.

➢ Peristaltic Pump:
➢ Pushes the reagent fluids and patient sample through the tubing to the
Electrode Module out to the waste bottle.
➢ Fluid is drawn into the analyzer as the flexible tubing is pressed by the
rollers of the pump and drawn through the tubing via the squeezing action
of the rollers on the tubing.
•

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➢ The Waste Module:
➢ is the container that
collects the patient
sample after analysis.
➢ It has to be properly
collected and disposed of;
it has blood in it so it can’t
just be sent down the
drain.
➢ It has to end up with the
bio-hazardous waste.

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1) Out-of-date buffer solutions.

2) No calibration gas .

3) Poor Flushing .

4) Not taking the time to properly warm up the

analyzer.

5) Bad electrode .
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