Interpretation of neonatal blood gases, Part II: Disorders of acid-base balance.

Timely and accurate interpretation of blood gases is of paramount importance in providing comprehensive neonatal care. Disorders of acid-base balance may evolve quickly in respiratory problems or develop over time with metabolic imbalances. In many cases, the interpretation of acid-base disorders may be complicated by the mixed metabolic and respiratory origins of the disorder. An overview of the underlying physiology of acid-base balance and oxygen transport helps the nurse understand the causes and subsequent treatments of the various disorders. Such an overview was presented in part I of this series (Vol. 16, No. 5). This article presents a discussion of the four basic types of acid-base disorders. A systematic plan for blood gas evaluation is presented, along with several case studies illustrating the principles of blood gas analysis.