BASIC ELECTRICAL PRINCIPLES

Blood Gas electrodes are

Electrical
electrochemical devices Voltage
Current
that measures either
 CURRENT

Is the actual flow of electrons through a conductor

Amp: Unit of measure for current

 VOLTAGE

Electromotive force (e.m.f) responsible for moving the electron

Volt: Unit of measure of e.m.f

Voltage refers to the electromotive potential, but the actual

flow does not occur without a conductor, bridging the
positive(+) and negative (-) poles

Potentiometer: Measures the unknown voltage by

comparing it with a known reference voltage & equate these
changes with chemical measurements
 ELECTRICITY

Is a form of energy that results from flow of electrons

through a conductor

An energy source is necessary to provide the power

for the flow
 ELECTRON PUMP (ENERGY SOURCE
THOUGHT OF AS AN ELECTRON PUMP)
Cathode ( Negative pole)

Electrons flow away from the

negative pole, through a
conductor towards the positive
pole

Anode (Positive charged pole)

PARAMETERS MEASURED BY BLOOD
GAS ANALYSIS
Directly measured parameters

 Hydrogen ion concentration (PH)

 Carbon dioxide tension (PaCO2)

 Oxygen tension (PaO2)

PARAMETERS MEASURED BY BLOOD
GAS ANALYSIS
Additional/ Optional parameters

 Base excess (derived)

 Bicarbonate/ Standard bicarbonate concentration (derived)

 Na+/ K+/Ca+ concentrations

 Lactate

 Haemoglobin

 Carboxyhaemoglobin and other abnormal haemoglobin

ELECTROMECHANICAL CELL SYSTEMS

An apparatus that consists of 2

electrodes placed in an
electrolyte solution
All the traditional analytical
devices used in blood gas
analysis is referred to as
electrochemical systems (Blood
gas electrodes)- PH/ PCO2/PO2
electrodes
 HALF CELL
A single electrode terminal within an
electrolyte solution is a half cell.
Blood gas electrodes require 2 half cells to
function

Working half
There
cells (where the Reference half cells
are 2
actual chemical
types
analysis occurs)
 PH
PH is the negative logarithm to the base 10 of the
hydrogen ion concentration
(PH is a measure of the hydrogen ion activity in a liquid)

PH= -log [H+]

Normal PH of arterial blood gas sample= 7.35-7.45

 Acid solutions: Proton donors- Predominance of H+

 Base: H+ acceptor
SI Unit used to define the
acidity/ alkalinity of the
blood= [H+] expressed in
nmol.L-1
Hydrogen ion concentration is expressed in terms of PH
units measured using glass electrodes (can also be
calculated using the Henderson-Hasslebalch equation)
Normal Hydrogen ion concentration= 35-45nmol/L

PH=7.0 100nmol/L [H+]

PH=8.0 10nmol/L [H+]

PH=6 1000nmol/L [H+]

Normal Blood [H+] = 40nmol/L (0.00004mmol/L )

at 37 degrees (PH=7.4)
 MEASUREMENT OF PH

Use of indicators

Calculate by using the Henderson-Hasselbalch equation

Use of electrodes (best & accurate)

 METHODS AVAILABLE FOR
MEASURMENT OF ARTERIAL CO2
TENSION
 In conscious patients with normal lungs the PCO2 of
arterial blood is approximately = end tidal or alveolar
PCO2

 Increase in alveolar dead space in anaesthetized patients

& patients with lung disease.

This results in an arterial to end tidal PCO2 difference

• In anaesthetized patients with normal lungs the end tidal
PCO2 is = 5mmHg (0.7Kpa) lower than arterial PCO2

• In patients with lung disease this difference can be as

much as 15-20mmHg (2-3Kpa)
 METHODS AVAILABLE FOR
MEASUREMENT OF ARTERIAL
CO2 TENSION
1. Rebreathing methods (measure mixed venous PCO2)

2. Calculate using the Henderson Hasslebalch equation

3. Astrup interpolation technique

Based on the linear relationship between PH and log PCO2 over the
physiological range

PH on the x axis & PCO2 plotted on a logarithmic scale on the y axis

Principle of the Astrup interpolation technique is plotted on a
Siggard-anderson nomogram
 METHODS AVAILABLE FOR
MEASUREMENT OF ARTERIAL
CO2 TENSION
4. Chemical analysis (by analysing a gas bubble equilibrated with
blood)

5. CO2 Electrodes
 METHODS USED TO ASSESS
OXYGENATION
Measure the O2 tension (PaO2)
by analysis of a gas bubble Saturation (SaO2) by
equilibrated with a blood sample/ photometric techniques
by using oxygen electrodes

Content of O2 (CaO2) by
vacuum extraction &
chemical absorption or by
galvanic cell analyser
Saturations & tension are necessary to define the dissociation curve

Content measurements are required when O2 transport is being

considered
 PH ELECTRODES (SANZ ELECTRODES)

A versatile electrode which can measure samples of blood,

urine or CSF

Measures the activity of the hydrogen ions in a sample

Consists of 2 half cells
PH ELECTRODE
PH ELECTRODE
 COMPONENTS
Ion- selective electrode utilizes a glass membrane which is selectively
permeable to hydrogen ions

* A glass electrode, the

measuring electrode-
(Silver/Silver chloride-
Ag:Agcl) incorporating a bulb
made of PH sens`itive glass
holding a buffer solution
*A calomel reference electrode
(mercury/mercury chloride-
Hg:Hg2CL2) which is in contact
with a potassium chloride
solution via a cotton plug

*Arterial blood sample is in *A meter to display the

contact with the potassium potential difference across the 2
chloride solution via a electrodes
membrane
 MECHANISM OF ACTION

Each electrode consists of 2 conductors

Metal component which conducts electrons

Electrolytic component which conducts ions

A potential difference (Electromotive Force/e.m.f) exists at
the interface between the 2 conductors
This is referred to as the electrode potential
This e.m.f is directly proportional to the difference between
the PH of the solutions
MECHANISM OF ACTION
Ag/Agcl: Ag coated with a layer
of Agcl

Calomel: Mercury coated with

mercurous chloride in contact
with saturated KCL

Glass electrode produces an

e.m.f which is approximately
60mV per PH unit change at 37
degrees Celsius
MECHANISM OF ACTION

*The reference electrode

maintains a constant potential
*The PH within the glass
remains constant due to the
action of the buffer solution.
However, a gradient exists
between the sample & the
buffer solution, which results
in an electrical potential
*Using the 2 electrodes to
create an electrical circuit, the
potential can be measured
MECHANISM OF ACTION

*One electrode is in contact

with the buffer & the other
is in contact with the blood
sample
*A linear electrical output
of about 60mV per unit PH
is produced
*The 2 electrodes are kept
at a constant temperature
of 37 degrees Celsius
 MECHANISM OF ACTION

Internal resistance of the cell is high. Therefore to

minimize the amount of current drawn from the cell and
to ensure an accurate reading of e.m.f., a voltmeter with
a very high input impedance is used (10-100 mega ohms
at 25 degrees)
 CALIBRATION
Calibration - uses 2 specific buffers with approximate
values
 6.840 buffer (zero point/low point buffer)
 7.384 buffer (high point/ slope point buffer)
 CALIBRATION (CONT…..)
*Each buffer is injected into the sample chamber, one at a time

*The values of the buffer injected, should be displayed on the ABG

machine within a specific SD

*Standard deviation for PH is +/- 0.005

*If value displayed is within the SD, machine is electronically

calibrated

*If value displayed is outside of the SD, machine needs to be

adjusted
 ADVANTAGES

*Versatile

*Unaffected by solution to be measured

*Can be used with solutions & suspensions

*Compact
 DISADVANTAGES

*Deteriorate with time

*Electrodes must be kept cleaned regularly & ensure no

proteins accumulate upon them

*Should be calibrated before use

 CO2 ELECTRODE
(SEVERINGHAUS ELECTRODE)

A modified PH electrode
(It is a PH sensitive glass
electrode)
The PH sensitive glass is in
contact with a thin layer of
bicarbonate buffer
CO2 ELECTRODE
CO2 ELECTRODE
 COMPONENTS
*A PH sensitive glass electrode with Ag:Agcl reference
electrode forming its outer part

*The electrodes are surrounded by a thin film of an

electrolyte solution (sodium Bicarbonate)

*A CO2 permeable rubber or Teflon/ Silicone membrane

*Bicarbonate buffer is trapped in a nylon mesh space

* Whole unit is maintained at 37 degrees Celsius

MECHANISM OF ACTION
•Blood comes in contact with
the semipermeable membrane
made of silicone rubber that
allows CO2 to cross it

•Other side of the membrane

contains the sodium bicarbonate
solution which is in direct
contact with the PH sensitive
glass

•This solution is also in contact

 MECHANISM OF ACTION
• A chemical reaction occurs in the bicarbonate solution
as CO2 diffuses in to it

• CO2 +H2O H+ + HCO3-

• This chemical reaction (Hydrolysis reaction) produces

H+ & results in a PH change within the solution

• Change in PH is measured by the glass electrode

• PH change is directly proportional to the PCO2

 MECHANISM OF ACTION
• 1.25mmHg PCO2change 0.01 PH unit
change

• Corresponding voltage change is converted into PCO2

units & is reflected on the voltmeter
 MECHANISM OF ACTION
• Response Time: Depends on the thickness of the
membrane
Usual size of the membrane= 1 micrometer
Usual response time = 0.5-3 minutes

• Sensitivity
Depends on the concentration of the solution
Maximum sensitivity- 0.01mmol/L Bicarbonate solution
 MECHANISM OF ACTION
CO2 electrode amplifier should be able to
discriminate small changes (should be very sensitive)

Problems in practice & safety:

 The integrity of the membrane is vital for

accuracy

 Slow response time (because diffusion of

CO2 takes 2-3 minutes)
 CALIBRATION

Uses 2 specific concentrations of humidified CO2

4% and 8%

The electrode is calibrated by equilibrating the buffer with

these 2 known CO2 concentrations to establish the
relationship between PH & PCO2
WHAT IS CALIBRATION?

Calibration procedures are

performed to ensure
appropriate electronic
function of the electrodes
Performed every 30
minutes automatically by
the ABG machine
Performed on the PH/
PCO2/ PO2 electrodes
Two point calibration: A low concentration & a high
concentration is used at both ends of the physiological
range to be measured

Multiple point calibration (3 or more points): Verifies

whether the gas analysis is linear or not
POLAROGRAPHIC (CLARK) OXYGEN
ELECTRODE

This measures the oxygen partial pressure

in a blood sample
POLAROGRAPHIC (CLARK) ELECTRODE
POLAROGRAPHIC (CLARK) ELECTRODE
OXYGENELECTRODE
 COMPONENTS
* A platinum (or
gold) cathode
sealed in a glass
body- 2 n.m in
diameter

*Power source of *A silver/silver

700mV (600mV- chloride anode
800mV)

*An oxygen-
permeable Teflon *A sodium chloride
membrane (or electrolyte solution
polypropylene) (or phosphate
separating the buffer stabilised
solution from the with KcL)
sample
MECHANISM OF ACTION
*Oxygen molecules cross
the membrane into the
electrolyte solution at a rate
proportional to their partial
pressure in the sample

*Small electric current flows

when the polarization
potential is applied across
the electrode (in the
presence of O2 molecules in
the electrolyte solution)
Electrons are donated by the ANODE

Electrons are accepted by the CATHODE

The circuit is completed by the input terminal of the

amplifier
Cathode Reaction:
O2 + 4e 2O- -
2O- - + H2O 4OH-
O2 + 2H2O + 4e- = 4OH-

Electrolyte Reaction:
NaCl + OH- = NaOH + Cl-

Anode Reaction: AgCl is oxidised

Ag + Cl- = AgCl + e-
1. In the vicinity of the cathode oxygen tension is
reduced thereby creating a diffusion gradient for
oxygen between the sample & the cathode

2. This movement of O2 enables the process of electro-

reduction to proceed

3. Produces small currents (10- 10Amperes/Kpa of oxygen)

4. Higher the PO2 in the sample, steeper the gradient &

greater the current produced
Small current Measures as a voltage drop
across a high resistance rather than using an ammeter

The electrode is kept at a constant temperature of 37

degrees Celsius
 CALIBRATION

Zero Slope point

Use 2 gas samples
O2 free N2 10-20% O2

RESPONSE TIME
30-60 seconds
 Problems in practice

*The membrane can deteriorate & perforate, affecting

the performance of the electrode

*Regular maintenance is essential

*Protein particles can precipitate on the membrane

affecting its performance
 OTHER METHODS
• Intravascular monitoring of oxygen tension using
miniature electrodes

• Fluorescence-based blood gas analysis

• Transcutaneous electrodes
TRANSCUTNEOUS ELECTRODE
TRANSCUTNEOUS ELECTRODE

Advantages in
monitoring blood
gases non-invasively

Incorporat
Useful in
ea
infants,
heating
neonates
element

Similar principles to
those used in blood
gas analysers
 Electrode is attached to the skin to form an airtight seal
using a contact liquid

 Area is heated to 43 degrees Celsius (at this temperature

the blood flow to the skin increases) capillary
oxygen diffuses through skin measurement
of the diffused gases by the attached electrode
 PROBLEMS

*Problems with surgical diathermy

*Less accurate

*Slow response time

*Reads low with severe hypotension &

microcirculatory perfusion failure
 SUMMARY

*PH electrode: 2 half cells linked via the sample

*The electrical potential produced is proportional to the PH of the
sample
*Carbon dioxide electrode: A modified PH electrode with a slow
response time, maintained at 37 degrees Celsius
*Polarographic oxygen electrode: consists of a platinum cathode,
Ag/AgCl anode & an electrolyte solution, membrane & polarization
potential of 700mV
The flow of the electrical current is proportional to the oxygen
partial pressure in the sample
*PCO2, PO2 & PH are measured directly, other values are calculated
*To ensure appropriate functioning of the electrodes, calibration
procedures need to be performed
 ESSAY QUESTIONS IN THE PAST
(2000-2013)
*November 2001 –Q2 (Interpretation of an ABG
reading and physical principles of blood gas
electrodes)

*March 2007- Q3 (Transcutaneous oxygen electrode)

*August 2009- Q2 (Similar to the Q in November

2001)

*August 2011- Q1 (Measurements used to assess the

adequacy of oxygenation)