The clinical value of cord blood gas analysis lies in its ability to provide objective evidence of asphyxia at the moment of birth. [1] How to Read a Venous Blood Gas (VBG) - Acadoodle Remember, the umbilical vein is carrying . Interpreting ABGs (Arterial Blood Gases) Made Easy | Ausmed In summary, these studies have confirmed that cord-blood lactate concentration is a good predictor of cord-blood pH and base excess, and that it is at least as good as pH and base excess in predicting outcome. Specs: Laminated 8.5 X 11 inches (21.6 X 27.9 cm) ISBN: 978-1-937967-06-2 Item No: 3rd Ed Nomo Add to cart The mother was a 26-year-old, gravida 4, para 3, aborta 0, with an intrauterine pregnancy at 40 0/7 weeks' gestation by good dates. In: McLaren A (ed): Advances in reproductive physiology. Normal Arterial Blood Gas Values pH : 7.36-7.44 PaCO2 : 36-44 mm Hg HCO3 : 22-26 mEq/L Legal Notices and Disclaimer All Information contained in and produced by the Pediatric Oncall system is provided for educational purposes only. The book makes the distinction between acute and chronic disorders based on symptoms from identical ABGs. Blood cord gases results can be used as an important piece of evidence in birth injury litigation. When she inhales, she picks up oxygen into her blood that is carried to the placenta and fetus. The pH, PCO2, and base deficit change quite slowly in a completely occluded umbilical vessel, likely because much of the surrounding tissue (Wharton's jelly) has very little metabolic activity and accordingly utilizes very little oxygen and produces very little carbon dioxide. Although uncommon, the venous sample also may demonstrate significant respiratory and metabolic acidosis. The solution, which is standard practice in some units, is to sample blood within seconds of birth directly from the still pulsating unclamped umbilical cord, rather than from a separated clamped cord segment. Analyzing cord blood gases (oxygen O2 and carbon dioxide CO2) from the umbilical artery is believed to be a good representation of the fetal acid-base status immediately before birth. Although widened pH differences are almost always associated with cord occlusion with terminal fetal bradycardia, rarely the pH difference falls within the normal range, 0.04 0.10. WbmedCentral. ABG interpreter - calculator (17) However, there is no clear evidence that volume expansion is helpful in neonatal asphyxia. The intended purpose of this review article is to detail the clinical value of determining acid-base parameters particularly pH and base excess of umbilical-cord blood. Acidosis with nuchal cords and normal Apgar scores. However, it seems safe to assume that a difference of 4 mmol/L or more is significant. Difference Between Arterial and Venous Blood Gas Details about pH pH=pK + log (HCO 3 /H 2 CO 3) (Henderson-Hasselbach euqation) pK=constant, it is the pH value at which H 2 CO 3 Metabolic acidosis develops because when tissue cells are severely depleted of oxygen, aerobic metabolism of glucose is compromised, and cells must depend for their function and survival on less effective anaerobic pathways that result in reduced ATP (energy) production and, importantly for this discussion, accumulation of metabolic acids (principally lactic acid) [6]. Manor et al [18] determined that blood gas values of cord blood stored in a capped heparinized syringe remain sufficiently stable for an hour at room temperature. However, there is an apparent consensus among those who have studied the issue that measurement of cord-blood lactate measurement has potential that should be further investigated. For many years it has been standard obstetric practice to clamp the umbilical cord within seconds of birth, a policy that is, as discussed above, coincidentally fortuitous for the most accurate assessment of neonatal acid-base status. We serve the following localities: Baltimore; Prince George's County including Bowie, Laurel, Landover, Hyattsville; Anne Arundel County including Glen Burnie; Baltimore County including Cockeysville, Glyndon, Hunt Valley, Jacksonville, Lutherville-Timonium, Owings Mills, Parkville, Reisterstown. Although these arterial blood pressure measurements were taken in fetal sheep, they are thought to be a reasonable estimate for the human fetus. Results: The cord blood collected from 160 newborns was analyzed in this study. What about a PO2 level? Blood gas analysis is a commonly used diagnostic tool to evaluate the partial pressures of gas in blood and acid-base content. Basal Energy Exp. Abnormal cord blood gas results are a marker for a birth injury. The readout from the machine quotes normal values based on the assumption that the sample analysed is arterial (an ABG). The validation of paired (arterial and venous) samples is based on minimum arterio-venous (A-V) differences for pH and pCO2 experimentally determined by Westgate et al [2]. Presented by Ellis Jacobs, PhD, Assoc. Our specific aim was to develop a standardized clinical care pathway, ensuring timely identification and evaluation of neonates with umbilical-cord acidemia at risk for HIE.METHODS. Molar Heat Vaporization Calculator. Metabolic acidosis is when there are high acid levels in the body that originated from impaired kidney function. It is a red flag that indicates the presence of hypoxia during delivery. Tic Tac Toe Method Arterial Blood Gas (ABG) Interpretation for Nurses Benirschke and Kaufman (10) have observed that cord compression (presumably cord occlusion followed by terminal fetal bradycardia) leads to congestion in the terminal capillaries and an increase in villous blood volume, sometimes by more than 50%. Javascript Cord Gas Analysis Value Normal Term Arterial Blood (Mean + SD) 1 Normal Preterm Arterial Blood (Mean + SD) 1 Sample Value Comments pH 7.27 + 0.069 7.28 + 0.089 PCO 2 (mm Hg) 50.3 + 11.1 50.2 + 12.3 HCO3- (mEq/L) 22.0 + 3.6 22.4 + 3.5 - pH without respiratory component 2 Base excess (mEq/L) -2.7 + 2.8 -2.5 + 3 3 1. Important issues surrounding cord blood sampling will also be discussed. Effect of Delayed Cord Clamping on Umbilical Blood Gas Value - LWW A developing baby does not breathe in the same way they would after birth. Value: Normal Range: Abnormal Values: pH. Input pH : Input pCO 2 : HCO 3 = Base Excess = . Tight nuchal cord and neonatal hypovolemic shock. Am J Obstet Gynecol 2010; 202: 546 e1-7, Nordstom L. Lactate measurement in scalp and cord arterial blood. Studies have shown this is a vital component to determining the health of your baby. Arterial blood gases (ABGs) are commonly used for estimating the acid-base status, oxygenation and carbon dioxide concentration of unwell patients. An arterial blood gas (ABG) is a test that measures the oxygen tension (PaO 2 ), carbon dioxide tension (PaCO 2 ), acidity (pH), oxyhemoglobin saturation (SaO 2 ), and bicarbonate (HCO 3) concentration in arterial blood. The purpose of this test is to analyze the neonate's ventilatory status by measuring the pH and carbon dioxide concentration in the blood. Below, the venous and arterial cord gases each have been "normalized" to a \(P_{CO_{2}}\) of 38 and 49 mmHg (the mean normal venous and arterial \(P_{CO_{2}}\)), respectively, as is done artificially by the equation used to calculate the base deficit in blood gas analyzers. From an obstetrics perspective, these can be challenging to really interpret, but the simple interpretation is often worth some CREOG points if you can analyze these systematically. The umbilical cord was tight around the shoulder and body. (21,22) In the current case, the difference in the degree of metabolic acidosis between venous and arterial samples is not great (BD 7 mmol/L versus 11). Calculate Anion Gap. Am J Obstet Gynecol 1997; 176: 957-59, Omo-Aghoja L. Maternal and fetal acid-base chemistry: A major determinant of outcome. HIE is a condition of brain/neurological dysfunction caused by perinatal asphyxia. Importance of Interpreting Umbilical Cord Blood Gases in Newborns Info. If is preferable to obtain both arterial and venous umbilical cord blood samples for analysis. If a baby has acidosis, you will see poor cord gases at birth. As one erudite neonatologist summarized, "Just add water! A widened difference in PCO2 (18 mmHg or greater) in the absence of a widened pH difference is clinically quite rare. and Towson; Carroll County including Westminster; Frederick County including Frederick; Harford County including Abingdon, Bel Air, Belcamp, and Forest Hill; Montgomery County including Germantown and Rockville; Howard County including Ellicott City and Columbia, Washington, D.C. and Washington County including Hagerstown. In short, significant cord metabolic acidosis (pH <7.0 and base excess, Currently, the only effective treatment for HIE is controlled cooling of the baby to a rectal temperature of 34 0.5 C for 48-72 hours. Case of the Missing Cord Gases: No Standing Orders or Reminder to Provider to Order Umbilical Cord Gases provide evidence of infant's condition at birth relative to acidosis & labor Need both umbilical arterial gases And umbilical venous gases Can cut & clamp cord & set aside until newborn's status is determined Espresso: Umbilical Cord Gas Interpretation - CREOGS Over Coffee A base deficit (i.e., a negative base excess) can be correspondingly defined by the amount of strong base that must be added. - SLE The interpretation of blood cord gas levels can also be used by malpractice lawyers and medical experts to show the severity of damage that occurred during delivery by citing the specific pH and base deficit levels. The blood samples were collected immediately after birth in the operating room and then sent for blood-gas analysis. However, arterial blood can be difficult to obtain due to weak pulses or patient movement. Truly UNDERSTAND blood gases! Interpretation of blood gases PART I Once the fetus uses this blood, it is carried away from the heart and back to the placenta by both umbilical arteries into the placenta and then to the mother. SID means Strong Ion Difference (SIDa and SIDe for SID apparent or effective). If the two samples return similar results (i.e. The intrapartum acid-base status, the status of the oxygen and other gases in the fetus and the umbilical cord after birth is important in establishing the link between events before and shortly after delivery. The assessment should take place within 60 minutes. Collecting and analyzing cord blood gases. Titration Calculator. Well summarized and easy to under stand and remember . 08 Sep 2021. Some blood gas analyzers also measure the methemoglobin, carboxyhemoglobin, and hemoglobin levels. Birth injury lawyers also need to work closely with a medical expert to prove the cause and timing of the birth injury. Relationship Between Umbilical Cord Gas Values and Neonatal - LWW - diabetes The test also checks the balance of acids and bases, known as the pH balance, in your blood. They should take the time to examine the process of taking blood cord gas samples and identify any possible technical errors that make the results invalid. Acta Paediatr 1963;52: 497-512. Then label each "column" as "acid", "pH", and "base". Interpreting Umbilical Cord Blood Gases, X. Normal arterial blood cord gases values in a full-term newborn: Normal blood cord gases levels in a preterm newborn: All values are 1 standard deviation. Evaluation of the newborn's blood gas status - OUP Academic Molar Mass Of Gas Calculator. At term, normal mean umbilical venous blood pressure is 4.9 mmHg, whereas normal mean aortic blood pressure is about 52 mmHg. Since acid-base status is in flux during the perinatal period, the timing of isolating a sample for analysis is crucial. Venous blood gas (VBG) interpretation - Oxford Medical Education On the other hand, blood in the two umbilical arteries reflects the fetal status. An ABG calculator is a tool that provides an easy way to determine the acid-base status by inputting the pH, PaCO2, and HCO3- values. This smartphone app focuses on the preanalytical phase of blood gas testing and what operators can do to avoid errors. However, because lactic acid crosses the placenta poorly (1), a greater base deficit in the arterial cord blood sample indicates the presence of umbilical vein occlusion with at least some interval of partially restored umbilical arterial blood flow. Benirschke K, Kaufman P. Architecture of normal villous trees, In: Pathology of the Human Placenta, 2nd edition. Paediatric Child Health 2012; 17: 41-43, Mokorami P, Wiberg N, Olofsson P. Hidden acidosis: an explanation of acid-base and lactate changes occurring in umbilical cord blood after delayed sampling. Universally obtained umbilical cord gas values and Apgar scores were extracted. Venous Blood pH Calculator - Description | Blood The chart is 8.5 x 11 inches and is laminated so that it can be easily cleaned if used at a patient's bedside. Observations on fetal heart rate and fetal biochemistry III: Base deficit of umbilical cord blood. The slower the circulation is through the placenta, the greater the amount of oxygen diffusion from mother to fetus, and the higher the PO2 in the umbilical vein. ABG Quiz | Arterial Blood Gas | Geeky Medics The calculator also determines whether the state is compensated or uncompensated. Significant metabolic acidosis, widely defined as cord arterial blood pH <7.0 and base excess 12.0 mmol/L), occurs in around 0.5-1 % of deliveries [1]. 27509185, Explore selected articles curated by biochemist and journalist Chris Higgins, It is important to distinguish cord-blood metabolic acidosis and cord-blood respiratory acidosis; the latter is characterized by reduced pH but, Currently, the only effective treatment for HIE is controlled cooling of the baby to a rectal temperature of 34 0.5, needle aspiration of two blood samples (one venous, one arterial) from the excised clamped cord segment into preheparinized syringes, Immediately after birth, ideally before the babys first breath, an approximate 20-cm segment of cord must be isolated between two sets of two clamps. The base deficit is calculated using measured blood levels for acid (pH), dissolved carbon dioxide gas (PCO2), and bicarbonate HCO. You perform an ABG, which reveals the following results: PaO2: 7.0 kPa (11-13 kPa) || 52.5 mmHg (82.5 - 97.5 mmHg) pH: 7.29 (7.35 - 7.45) Umbilical cord O 2 and CO 2 Fetal cord gas values result from the rapid transfer of gases and the slow clearance of acid across the placenta. Use of umbilical cord blood gas analysis in the assessment of the newborn. However, a diagnosis of HIE depends in part on demonstrating significant cord-blood metabolic acidosis, and a normal arterial cord-blood pH and base excess result usually excludes the possibility of perinatal asphyxia, and thereby that any neurological signs and symptoms (including cerebral palsy) exhibited by the neonate is due to HIE. Cord blood P o2 and P co2 The blood gas analyser measures pH, P co2 and P o2 and then calculates base excess after normalising P co2. This calculator only differentiates between acute (pH abnormal) and compensated (pH normal). Together with other clinical measurements (including fetal heart rate [FHR] tracings, Apgar scores, newborn nucleated red cell counts, and neonatal imaging), cord gas analysis can be remarkably helpful in determining the cause for a depressed newborn. The most likely pathophysiology is as follows: Initially, in terminal cord occlusion, both the umbilical vein and the umbilical arteries are occluded. Loma Linda Publishing Company | 11175 Campus Street, Coleman Pavilion #11121, Loma Linda, CA 92354 USA | 1-302-313-9984 |, https://doi.org/10.51362/neonatology.today/20201115115457, None to many minutes (depending on timing of delivery). Teitel DF, Iwamoto HS, Rudolph AM. In addition to his current work, Dr. Amos is using his vast experience to launch Obie, a science-based app that offers personalized fertility advice. Fetal acid-base balance can be assessed in a number of ways: Antepartum, by percutaneous umbilical cord blood sampling. A. Khazin AF, Hon EH, Yeh SY. Effects of maternal oxygen administration on fetal oxygenation during reductions in umbilical blood flow in fetal lambs. At times, congestion might lead to a decreased efficiency of the transfer of carbon dioxide and oxygen between mother and fetus. To my knowledge, all animal studies of fetal cord occlusion involve sudden and complete occlusion rather than any period of continued venous occlusion with the restored arterial flow. Dunn PM. Australia and New Zealand J of Obstetrics and Gynaecology 2010; 50: 318-28, Get fertility advice personalized for you, Umbilical cord base excess or base deficit, needle aspiration of two blood samples (one venous, one arterial) from the excised clamped cord segment into pre-heparinized syringes. Arterial Blood Gas (ABGs) Analysis Ultimate Guide - Nurseslabs Blood gas interpretation for neonates Blood gas interpretation for neonates Key messages Blood gases are helpful to assess the effectiveness of ventilation, circulation and perfusion. "(20) (saline). This acid base calculator estimates both the anion gap and provides you with an arterial blood gas interpretation. The contact form sends information by non-encrypted email, which is not secure. After separation from maternal circulation, and throughout life, oxygenated blood is carried in arteries from lungs to the tissues and deoxygenated blood is carried from tissues back to the lungs in veins). Oxygen and nutrients diffuse across the placental membrane from maternal arterial blood and is transported to the fetus via a single large umbilical vein. Pearls/Pitfalls pH PCO mm Hg HCO- mEq/L Sodium mEq/L Chloride mEq/L Albumin RESULTS: We analyzed data from 29,787 deliveries. Clamping the umbilical cord is standard procedure when a baby is born. The initial neonatal hemocrit was 20% and the hemoglobin was 8. An arterial blood gases (ABG) test is a blood test that measures the acidity, or pH, and the levels of oxygen (O2) and carbon dioxide (CO2) from an artery. Umbilical cord blood analysis is designed to give a picture of the acid-based balance of the infant at the moment of birth. It is also important to get accurate results. Membranes ruptured spontaneously two hours prior to admission. Because of increasing occluding forces, or as fetal blood pressure begins to falter secondary to fetal hypovolemia and cardiac hypoxia, the fetus' ability to continue umbilical artery blood flow will end. Blood gas interpretation for neonates | Safer Care Victoria Obstet Gynecol 1984; 63: 44-47, Valero J, Desantes D, Perales-Pulchat A. Once you have drawn the blood, what must you do with the syringe? Interpreting Umbilical Cord Blood Gases: Uteroplacental Insufficiency Symptoms among affected neonates include hypotonia, poor feeding, respiratory difficulties, seizures and reduced level of consciousness. Calcium Equivalents. This potential safety audit function of universal cord blood gas testing is addressed by a recent study [1] that suggests adoption of a universal testing policy resulted in improved perinatal outcomes. Indeed, most (around 75 %) babies with significant metabolic acidosis (pH <7.0, base excess. Unfortunately it is more difficult to sample arterial than venous cord blood because umbilical arteries are much smaller and less visible than umbilical veins [20]. The pH of venous blood should be between 7.31 and 7.41, whereas arterial blood should be between 7.35 and 7.45. We calculated Spearman correlation coefficients and receiver operating characteristic curves for various levels of umbilical artery pH, base excess, and Apgar scores. WARNING. Analyzing cord blood gas levels is often the best indicator of hypoxia or ischemia during the delivery period. Neonatal Blood Gas Interpretation Nursing CEUs | CEUfast Am J Perinatol 1994;11:255-9. Umbilical-cord acidemia may indicate perinatal asphyxia and places a neonate at increased risk for hypoxic ischemic encephalopathy (HIE). In: Handmaker H, Lowenstein JM (eds): Nuclear medicine in clinical pediatrics.. New York, Society of Nuclear Medicine, 1975, pp167-185. 16,17 Current cord blood gas reference ranges were defined when early cord clamping at less than 30 seconds was routinely practiced. Arterial Blood Gas (ABG) Analyzer - MDCalc Arterial Blood Gas (ABG) Analyzer Interprets ABG. There are maternal, uteroplacental, and fetal factors which can have an impact on umbilical cord blood gases. It is vital, therefore, that the acid-base parameters (pH, base excess (BE) and lactate) derived from arterial rather than venous cord blood are used to assess neonatal condition. Info | This calculator provides all the parameters derived from Stewart's theory of acid-base balance. Interpreting umbilical cord blood gases and detecting birth asphyxia The most important measurements in a blood gas test for evaluating a baby's current condition and prognosis are the pH and the base deficit. So when HCO 3 - is raised the pH is increased as there are less free H+ ions (alkalosis). Cord blood gas analysis determines the fetal metabolic condition when umbilical circulation stops during childbirth. SIG is the Strong Ion Gap. First, the A-V difference of lactate in cord blood has not been sufficiently clearly defined, so there is no way of reliably confirming that a lactate result relates to cord arterial blood. The test is used to check the function of the patient's lungs and how well they are able to move oxygen into the blood and remove carbon dioxide. Benefits of introducing universal cord blood gas and lactate analysis into an obstetric unit. HCO 3 - is a base, which helps mop up acids (H+ ions). Both forms of acidosis can cause neurological issues that can be temporary or permanent depending on how severe the damage is. PDF PERINATAL LEGAL RISKS: Documentation & Communication South Australian Perinatal Practice guidelines, Umbilical cord blood gas sampling, 2014, Which interpretation of these umbilical cord and initial neonatal blood results is correct? May contain information that is not supported by performance and intended use claims of Radiometer's products. Gruenwald P. Growth of the human foetus. Am J Obstet Gynecol 1997;177:274-81. ABG analysis can be easy! Very important update. Arterial Blood Gas Interpretation Calculator. Umbilical cord blood gas sampling is the most objective determinant of fetal metabolic condition at the moment of birth. Draw your tic tac toe . (18,19) This is difficult to study because of the rarity of delivery room resuscitation that includes volume expansion. Use of volume expansion during delivery room resuscitation in near-term and term infants. Btu Calculator. Ron helped me find a clear path that ended with my foot healing and a settlement that was much more than I hope for. Both umbilical cord blood venous or arterial values may be influenced by many different conditions including but not limited to: In order to examine the fetus' status, umbilical artery blood needs to be examined as this is the blood coming from the baby (as opposed blood going to the baby through the umbilical veins). The S.T.A.B.L.E. Program: Blood Gas Interpretation Chart, 3rd Edition Please do not include any confidential or sensitive information in a contact form, text message, or voicemail. ARC Blood Gas Analysis 6 125 (H+).The hydrogen ions are buffered by desaturated hemoglobin, and HCO3 - is transported out of the eryth- rocytes into the plasma (Figure 6-3).1 As oxygen is unloaded from hemoglobin along the tissue capillaries, The respiratory acidosis in the venous sample is mild; the base deficit is within normal limits. Efficacy depends on initiating this hypothermic treatment within 6 hours of birth. The usual relationship between venous and arterial values is intact; the venous pH and PO2 are higher, and the venous PCO2 is lower. Test your knowledge on the web's most interactive blood gas learning tool. Altogether, they help to determine the status of the patient - their acid-base balance. Obstet Gynecol 1992; 79: 959-62. Usher R, Shephard M, Lind J. One might use this estimate to calculate the maximum amount of blood a fetus could transfer to the placenta during cord occlusion associated with terminal fetal bradycardia. Significant metabolic acidosis (i.e. Due to thicker, muscular and innervated walls, arteries are also more painful to puncture than veins. Your body normally tightly regulates the amount of oxygen and carbon dioxide in your . The standard technique of sampling cord blood for gas and acid-base analysis comprises three steps: The purpose of cord blood gas analysis is to determine the acid-base status of the neonate at the moment of delivery. With an intact umbilical-placental circulation, any metabolic acidosis appearing in the umbilical arteries will almost instantaneously appear in the umbilical vein. Once the umbilical vein becomes occluded, a blood gas sample will only reflect the status prior to the occlusion. However, doctors can also use blood cord gases to defend birth injury lawsuits as well. The key difference between arterial and venous blood gas is that arterial blood gas test uses a small blood sample drawn from an artery while venous blood gas test is a comparatively less painful test that uses a small blood sample drawn from a vein. Arch, Duerbeck N, Chaffin D, Seeds J. Given these difficulties, it is widely recommended [2, 20-22] that blood from both artery and vein are sampled and analyzed, so that arterial blood results can be validated as truly arterial. Since the incidence of HIE is much lower (around 1.5/1000 live births [10]) than that of significant metabolic acidosis (0.5-1 % live births [1]), it is clear that HIE is not an inevitable consequence of significant metabolic acidosis. Wykoff M, Garcia D, Margraf L, Perlman J, et al. Cord Occulsion with Terminal Fetal Bradycardia Anatomy and Pathophysiology: Sequential Events and Approximate Timeline. Low pH levels caused by acidosis can result in hypoxic-ischemic encephalopathy, periventricular leukomalacia, seizures, brain hemorrhages, and cerebral palsy. Tight nuchal cord and neonatal hypovolemic shock. Because of decreased fetal movement complaint three days before admission, a non-stress test was performed and was reactive, but had several mild, variable decelerations. So long as these minimum differences in pH and pCO2 between the two samples are evident, it can be assumed that the two samples came from different vessels, and that the one with lowest pH and highest pCO2 came from an artery (Table I). This has medico-legal significance for resolving disputes about the cause of brain damage sustained at birth [11]. The umbilical vein transports blood from the placenta/mother to the fetus and the two umbilical cord arteries carry blood back to the placenta/mother. accurately in order to calculate exact base excess. Wiberg et al [31] argue that lactate may be superior to base excess because the former is a direct measure of metabolic acidosis, whereas base excess is an indirect estimated (calculated) value derived from measured pH and pCO2. Drawing Umbilical Cord Blood Gasses Flashcards | Quizlet The results from cord blood gases are frequently used as evidence in medical malpractice lawsuits by both attorneys and doctors as a marker for the harm done to the child and to prove whether negligence was involved in a child's injury. Menu vscode compare with clipboard. It is used to determine the extent of the compensation by the buffer system and includes the measurements of the acidity (pH), levels of oxygen, and carbon dioxide in arterial blood. NCCLS document H11-A4. The American College of Obstetricians and Gynecologists (ACOG) also favor a selective approach, stating that cord-blood testing should be applied in the following situations [22]: The Society of Obstetricians and Gynecologists of Canada (SOGC), by contrast, recommend that cord blood gas analysis be performed at all births [7]. The blood-gas values were statistically analyzed and reported. Your doctor may run a blood gas analysis or arterial blood gas (ABG) test if you are showing the signs of an oxygen, carbon dioxide, or pH imbalance such as confusion or difficulty breathing.