Can anyone help me with the terminology of Arterial Blood Gas Test?

[Gingergrrl]

I had an arterial blood gas test back in August and was told that the results were "Normal" and never received a copy. However, in light of multiple failed PFT tests which show my breathing at an average of 70% of normal and several doctors interpreting them as having a probable restrictive lung/airway disease, I requested a copy of the arterial blood gas test which was faxed to me today.

My absolute #1 symptom is shortness of breath and I am trying to get oxygen which my insurance will not cover (just to try it in a bad episode at home, knowing that it may not help me.) Whether my shortness of breath is ultimately due to autonomic causes, mast cell issues, mold/toxin exposure, or some other cause remains to be discovered but a high resolution CT scan of my lungs was normal.

Two items were flagged on my ABG test, the "BE" or base excess and the "P02" which I believe means the "partial pressure of oxygen" from my Google search. I am wondering if anyone else has had this test or understands these terms that could explain it to me so I can try to interpret my results. Per my doctor they are normal but per the lab, they were flagged as abnormal and are outside of the lab ranges so I am very curious how they fit with my total picture.

Any info is very much appreciated.

 

[Kati]

It's been a while since I have been a nurse let alone dealt with blood gases, but if I remember well, the PH is what is important. Base excess may mean your body is compensating by making more bicarbonate but it doesn't affect your PH. Things are usually pretty bad when your PH is affected though.

The only person who has a full picture is your physician, though, with the PFT, BG and clinical picture.

Best wishes.

 

[Valentijn]

Can you type out the relevant results?

 

[Gingergrrl]

It's been a while since I have been a nurse let alone dealt with blood gases, but if I remember well, the PH is what is important. Base excess may mean your body is compensating by making more bicarbonate but it doesn't affect your PH. Things are usually pretty bad when your PH is affected though.

The only person who has a full picture is your physician, though, with the PFT, BG and clinical picture.

Best wishes.

Thanks Kati and the PH was normal but the very top of the range. The range was 7.37 to 7.44 and mine was 7.44 but it did not get flagged and was considered normal. I wish my doc had interpreted it for me but he couldn't find it in computer system and just told me back in Aug that the test was normal. I got one of the nurses to fax it to me yesterday and saw myself that two items were flagged. I e-mailed her my questions and hoping she relays them to my doc who I do not see again until January. Am trying to get referred to a pulmonologist via another doc but this may take some time.

 

[Kati]

Thanks Kati and the PH was normal but the very top of the range. The range was 7.37 to 7.44 and mine was 7.44 but it did not get flagged and was considered normal. I wish my doc had interpreted it for me but he couldn't find it in computer system and just told me back in Aug that the test was normal. I got one of the nurses to fax it to me yesterday and saw myself that two items were flagged. I e-mailed her my questions and hoping she relays them to my doc who I do not see again until January. Am trying to get referred to a pulmonologist via another doc but this may take some time.

Your ph shows your arterial blood is not acidotic but borderline alkalotic (alkaline) The reason of that I really don't know especially considering your complicated medical history. The base excess basically shpw there has been attempt to compensate by sending out bicarbonates (that is unless you are consuming lots of sodium bicarbonate)

This is as far as I can go. Best.

 

[Gingergrrl]

Can you type out the relevant results?

Yes, will do this now. The first that got flagged as abnormal was "BE" which from Google I believe means "base excess." The range says: -2.5-2.5 which I thought meant negative 2.5 to positive 2.5 but my score is 2.0 which seems to be in the middle of the range. As I researched it though, it seemed like maybe you are supposed to be either -2.5 or +2.5 and since I am neither, it got flagged? My husband and I tried to understand it but just could not figure it out.

The second thing that got flagged was "P02" which from Google seems to mean "Partial pressure of oxygen." The range is 75-90 and mine was 106 and got flagged as high. At first it seemed as if I had too much oxygen which made no sense to us since my breathing is so poor but when I researched it, we found stuff that implied either too many RBC's or low blood volume and a term that explained high "P02" called "polycythemia" (although no doctor has given me this term, it was our own research which could be wrong.)

In light of the "restrictive airway disease" diagnosis on four PFT's from two allergists and while in the hospital in May (for MCAS gone crazy) combined with my severe shortness of breath, I now want a doc to explain this test to me. I see my cardio in a week and am going to ask him even though he did not run the test. My other docs want him to do an echocardiogram so hoping he agrees. I feel like this all relates some how to me having pulmonary edema from one liter of saline (in Nov 2014) and am hoping a doctor can put all the pieces together as I am not smart enough. It's very frustrating and makes me question my entire diagnosis (except the dysautonomia and MCAS which universally every single doc has agreed on.)

 

[Gingergrrl]

Your ph shows your arterial blood is not acidotic but borderline alkalotic (alkaline) The reason of that I really don't know especially considering your complicated medical history. The base excess basically shpw there has been attempt to compensate by sending out bicarbonates (that is unless you are consuming lots of sodium bicarbonate)

This is as far as I can go. Best.

I do not consume any sodium bicarbonate (zero) so it cannot be that. I don't grasp the base excess term and it seems like my number is inside the range unless it is not a range and you are supposed to be exactly -2.5 or exactly +2.5 so me being 2.0 is flagged for that reason? Is that how that one is scored? (am not asking for any kind of diagnosis, just wondering how the test is scored.)

 

[Kati]

@Gingergrrl here is an article on reading blood gases, but keep in mind this is for critical care patients.

http://www.medscape.com/viewarticle/763010

 

[Gingergrrl]

@Gingergrrl here is an article on reading blood gases, but keep in mind this is for critical care patients.

http://www.medscape.com/viewarticle/763010

Thank you and I read the article but still don't understand it in relation to my test results. Will show my cardio next week (even though he is not the doc who ran the test) and eventually to my MCAS doc in Jan.