Laboratory Lab results are too important to go anywhere else.

Blood Gases

ABG, VBG, Arterial Cord Blood Gas, Venous Cord Blood Gas, Capillary Blood Gas, Mixed Venous Blood Gas

Test Codes

Arterial: EPIC: LAB76, ABG, Venous: EPIC: LAB79, VBG, Capillary: EPIC: LAB78, CAPBG, Mixed Venous: EPIC: LAB5338, MVBG, Cord Arterial: EPIC: LAB3365, CBGA, Cord Venous: EPIC: LAB77, CBGV

Department

Chemistry

Instructions

Outpatient Blood Gas Collections

• Arterial: Appointments must be scheduled through the Beaumont Appointment Center at 800-328-8542. 

• Venous and Capillary: Samples are collected by phlebotomists at the Royal Oak Medical Office Building or the Troy Area B Laboratory without an appointment.

• Outpatient blood gas collections are not available at Farmington Hills or Grosse Pointe campuses.
  

Inpatient Blood Gas Collections

• Arterial and Capillary: Samples are collected at the Farmington Hills, Grosse Pointe, Royal Oak and Troy Hospital campuses by respiratory therapists or nursing. 

• Venous: Samples are collected by Phlebotomy at Royal Oak and Troy Hospital campuses, by physicians and nursing at Grosse Pointe campus, and by nursing at the Farmington Hills campus.

Specimen Collection Criteria

Collect: Arterial, venous, or capillary, heparinized whole blood.

• A 1 mL or 3 mL plastic syringe containing dry heparin is usually used to collect the specimen.
• At least 1–2 mL (0.3 mL for pediatric patients) of blood is needed to ensure proper assay.
• Arterial specimens are collected by a physician, nurse, or respiratory therapist. 
• Venous specimens, at Grosse Pointe, are collected by a physician or nurse.
• See Minimum Pediatric Specimen Requirements.

Collection Requirements:

• For specimens collected by syringe, any air bubbles present in the syringe must be immediately expelled, the needle removed, and the syringe tightly capped. The syringe is rolled between the palms of the hands to ensure mixing.
  • NOTE: The Radiometer safePico Self-fill™ syringe has a metal ball to ensure homogeneous mixing when the syringe is rolled between the palms of the hands.
• Characterization of oxygen enrichment, at the time of arterial puncture, is required. This may be expressed as FiO2 fractional inspired oxygen concentration provided (e.g., 0.50), FiO2% (e.g., 50%), room air, or nasal cannula flow rate in liters per minute. The FiO2 must be noted on the requisition or entered as part of the electronic order for any arterial blood gas specimens. It is not possible to fully evaluate arterial blood gas results without knowledge of the oxygen concentration or nasal flow rate being delivered to a patient at the time of blood draw. FiO2 is not required for venous blood gas orders.
• The specimen must be properly labeled.
• Place on wet ice for transport. Ice and Specimen must be kept separated.
  • Suggested: Place specimen in front pocket of the biohazard bag. Place ice in zip lock section of biohazard bag.
• The specimen must be transported immediately to the STAT Laboratory (Royal Oak) or to the Chemistry Laboratories.

Rejection Criteria

• Clotted specimens.
• Specimens not collected and processed indicated, including samples with unexpelled air.
• Specimens received past 1 hour from the time of collection or without a documented collection time.

Inpatient Specimen Preparation

The specimen must be transported STAT, on wet ice, to the STAT Laboratory (Royal Oak) or to the Chemistry Laboratories.

In-Lab Processing

Immediately analyze the whole blood, heparinized, iced specimen upon receipt.

Storage

Specimen Stability for Testing:

Room Temperature (20–26°C or 68–78.8°F): Unacceptable
Refrigerated (2–8°C or 36–46°F): 1 hour
Frozen (-20°C/-4°F or below): Unacceptable

Specimen Storage in Department Prior to Disposal:

Specimens are disposed within 8 hours of testing.

Laboratory

Dearborn Chemistry Laboratory
Farmington Hills Chemistry Laboratory 
Grosse Pointe Chemistry Laboratory 
Royal Oak STAT Laboratory
Troy Chemistry Laboratory
Taylor Chemistry Laboratory
Trenton Chemistry Laboratory
Wayne Chemistry Laboratory

Performed

Sunday – Saturday, 24 hours a day.
STAT and routine results are available within 15 minutes after receipt in the Laboratory.

Reference Range

See ABG Reference Ranges for Beaker LIS.

Test Methodology

Potentiometry, Amperometry, Absorption Spectrophotometry.

Interpretation

This assay includes: pH, PCO₂, PO₂, hemoglobin, oxyhemoglobin (%), carboxyhemoglobin (%), methemoglobin (%) and sulfhemoglobin (if present). Base excess, HCO₃ and TCO₂ values are calculated. PO₂ is not reported for venous blood gas orders_.

It is not possible to fully evaluate arterial blood gas results without knowledge of the oxygen concentration or nasal flow rate being delivered to a patient at the time of blood draw.

Blood from patients anesthetized with halothane may have unreliable PO₂ values due to the reduction of halothane by the PO₂ electrode.

Clinical Utility

Arterial blood gases are used in the evaluation of oxygen and carbon dioxide exchange and acid-base status. Arterial blood gases are also used in the assessment of asthma, chronic obstructive pulmonary disease (COPD) and other types of lung disease, pulmonary embolism, carbon monoxide poisoning, methemoglobinemia, sulfhemoglobinemia and in cardio-pulmonary bypass cases.

Venous blood gases are used to evaluate acid-base status but are less useful in assessment of blood oxygenation. Results are used to assess pH in infants, children, and adults in whom oxygen parameters are not needed. In many metabolic situations a venous pH is adequate to assess acid-base status, and arterial puncture is unnecessary. In cases of severe hypoperfusion central venous blood better detects hypercapnia and acidemia. The pH, PCO₂, and PO₂ from pulmonary arterial samples correlate with central venous specimens.

CPT Codes

82805

Contacts

Last Updated

10/16/2024