Application of Boston Compensation Rules in the Development of a Stepwise Approach for Novel Diagnostic Arterial Blood Gas Interpretation Method.

Abstract

Arterial blood gas (ABG) interpretation plays an indispensable role in health care. The total changes in hydrogen ion concentration or actual pH are due to both the changes in respiratory and non-respiratory (metabolic) components affecting the hydrogen ion concentration or pH in the acid-base homeostasis. Using this concept, an innovative ABG interpretation method was developed and published by the current author. The aim of this study is to apply the compensation rules and to develop a stepwise approach in this novel method to interpret various acid-base disorders. The total change in pH (ΔpH), non-respiratory hydrogen ion concentration (NRH+), changes in non-respiratory pH (ΔNRpH), and respiratory change in pH (ΔRpH) were calculated for 232 ABG samples. The expected pCO2 (Exp pCO2) or expected bicarbonate (Exp HCO3-) values were calculated using the compensation rules and compared with their actual given values. Few acid-base disorder cases were shown as examples comparing the physiological, standard base excess (Std BE) and parameters such as ΔpH, ΔRpH, and ΔNRpH values of novel ABG interpretation method which change in different acid-base disorders. The stepwise approach in this novel method appears to be much user-friendly providing interpretation of various acid-base disorders easily and quickly. This innovative method may help to overcome the challenging task of ABG interpretation. Samuel R. Application of Boston Compensation Rules in the Development of a Stepwise Approach for Novel Diagnostic Arterial Blood Gas Interpretation Method. Indian J Crit Care Med 2023;27(10):717-723.