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The ABG or VBG become very important clues as to the diagnosis of some of the sickest patients we see. They help in monitoring the improvement of patients on non-invasive ventilation, and gives us clues as to the causes of patients ventilation issues.

For those of you sitting the Fellowship Exam, you will get one or two blood gases so you must know them.

Key things to remember:

Always calculate an anion gap- if it’s raised, there must be a metabolic acidosis
Always check for compensation
Look for the triple abnormality by calculating the delta ratio. This will tell you if you have NRAGMA, RAGMA or Metabolic Alkalosis
When thinking of causes, think clearly. If you see an osmolar gap, chase the toxic alcohol poisoning.

Here is the link of how to work through the ABG


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