What do Cord Gas values mean?

In the different hospitals I have worked at over the years where the respiratory therapists either draw or run the umbilical cord gases I have often wondered about what the normal values of a cord gas was. Just from running a lot of cord gases I have came to my own conclusion of what a cord gas value should probably be but have never really looked into what the real normal values are and what a value out of the norm would mean.

I have done some research online to see what I could find out. Here are some fact about umbilical cord gases and the normal values:

• The umbilical cord blood is studied for the status of the fetal acid base. Cord gases are obtained to detect the presence or absence of acidosis and to decide whether the cause of the acidosis is respiratory or metabolic. Establishing the source and type of acidosis make it easier to a.) plan resuscitation b.) treat complications.
• Umbilical cord blood pH and acid-base balance is most useful in association with the delivery of an infant with a low APGAR score.
  
• Only newborns who have a persistent APGAR score of 0-3 for 5 minutes or longer and an umbilical artery blood pH of less than 7.00 are at risk of manifesting anoxic brain injuries.
• Premature infants are at higher risk for intracranial hemorrhage and subsequent neurological dysfunction, such as cerebral palsy. Without umbilical cord blood gas analysis, these neurological complications could be incorrectly attributed to intrapartum or birth asphyxia, especially if the latter is solely based on APGAR scores. Normal umbilical cord blood values in the premature infant virtually eliminate the diagnosis of significant intrapartum hypoxia or birth asphyxia.

The information I used above was found from different sources who are all basically saying the same thing. Now how about those normal values and the values the show a respiratory or metabolic acidosis.

As a reminder the umbilical cord is backwards as the Venous side carries the oxygenated blood and the Arterial side the unoxygenated blood. Doctors prefer to use the Venous cord blood but can assess PH with he arterial side also. Also these values are not set in stone, they are just a reference point, I have came across values the differ but very slightly.

After Birth­Normal Fetal cord blood pH and gas values:

	VEIN	ARTERY
pH	7.25 - ­7.35	7.28
p02	28­ - 32 mmHg.	16­ - 20 mmHg.
pC02	40­ - 50 mmHg.	40 - ­50 mmHg.
Base Excess	+/- 0 - ­5 mEq/Liter	+/- 0­ - 10 mEq/Liter

Abnormal Venous cord blood pH and gas values

	Respiratory Acidosis	Metabolic Acidosis
pH	<>	< 7.25
P02	Variable	< 20 mmHg
pC02	> 50 mmHg	45­ - 55 mmHg.
Base Deficit	< 10mEq/liter	> 10mEq/liter
	Respiratory Acidosis	Metabolic Acidosis
	Low pH	Low pH
	High pC02	Normal to high pC02
	Normal Base Excess	High base excess

As always I hope you have learned or been refreshed on this topic, I know just researching for this information I have learned a bit of information.

Thanks for reading.

Drive on RT's

It's Pouring!!!

Remember that "Wow it's been really slow for awhile now" thing I wrote a couple posts back? Well it's over now, tonight has become hell night, so I'm not able to blog about what I wanted to but I will at a later time.

Well I've been hit with a ton of COPD patients tonight along with multiple Chest Pain which cause use to do EKG's. It's just been crazy and we are assuming that it was the nicer weather that awoke all the bacterias up and now it's getting colder and we are expecting 3-9 inches of snow today, so yep weather and barometric pressure change can really effect those people with COPD and it's happening tonight at my little hospital. It's also happening at my wife's big hospital were she is a ER nurse, they have been just as busy.

Here in my little slice of heaven I am the only RT on a night so I'm running all over with the new patients we are getting and I'm only able to write a little due to forgetting to get the chance to do the controls on our ABG machines so I'm doing that now. Actually I walk into here one is stuck in the MS Windows start up screen and is spitting out paper as I speak slowly, now what the hell do I do? I'm not trained to mess with this type of problem, oh well we have 2 machines and I'm going to assume that the broke one will run out of paper soon.

Well enough typing for me right now the paper is yelping at me again so back out into the war against COPD and when this is over I have a couple days off to actually get to enjoy my Christmas presents.

I'm still driving on.