Arterial Blood Gases and Acid-Base Balance in Normal Children 1

Abstract

Robinson (1) studied the effect of age on the arterial blood gases and the acid-base balance of normal males from 5 to 91 years of age. In addition to the well known increase in oxygen combining capacity which occurs during childhood and adolescence, Robinson found moderately lower mean values for hemoglobin saturation in adults above 40 years of age, and slightly higher mean values for arterial CO2 content and CO2 tension in adults as compared with children. In the case of the alkaline reserve, mean values varied between 21.2 and 22.2 millimols per liter for all age groups except the youngest. Robinson found unusually low values of alkaline reserve in children 4 to 6 years of age. The present study was undertaken to supplement the work of Robinson in the years of childhood and adolescence, in order to establish more firmly the range of variation that may be expected in healthy children, and to provide a basis for the study of arterial blood gases and acid base balance in disease. MATERIALThe subjects of the study were drawn from three sources:1. Children of 10 years and younger were of both sexes. They had been carefully selected from patients at Bobs Roberts Memorial Hospital as representing physiologically normal states at the time the blood samples were drawn. Breakfast was withheld and the child was kept in bed until after the sample was taken.2. Subjects between 11 and 17 years of age were normal healthy boys 8 who came to the laboratory to participate in various tests for physical fitness. The results of most of these tests have been described earlier (2-5).

An Adaptation of the Nitrous Oxide Method to the Study of the Cerebral Circulation in Children; Normal Values for Cerebral Blood Flow and Cerebral Metabolic Rate in Childhood1

“…The differences found in pulse rate, blood pressure, hemoglobin concentration, blood gas concentrations, and blood pH were all to be expected in view of the established normal values for children (22,23). The mean cerebral blood flow in children, 106 ml.…”

Arterial Blood Gases and Acid-Base Balance in Cyanotic Congenital Heart Disease 1

“…are plotted on triaxial charts according to the method of Hastings and Steinhaus (9) and of Shock and Hastings (10). The shaded area in each chart represents the range of variation which we have found for normal healthy children of corresponding age groups and for adults (7). It is evident that in the great majority of cases the acid-base balance may be described as that due to fixed acid excess or to a combination of fixed acid excess and CO2 deficit.…”

“…Because age has been found to affect the concentrations of the blood gases (7), especially the HbO2 capacity, the CO2 content and the alkaline reserve, it was necessary to evaluate the results for an individual of a given age in terms of deviations from the mean values for that age. Normal values for children of different ages are given in the preceding report (7).…”

“…Normal values for children of different ages are given in the preceding report (7). Table I gives the results of single tests on each of 60 patients with cyanotic congenital heart disease, in terms both of absolute values and of deviations from the normal.…”

Renal Bicarbonate Reabsorption and Hydrogen Ion Excretion in Normal Infants*

“…It is well established that the concentration of bicarbonate in the plasma of normal infants is lower than that observed later in childhood and adult life (1,2). Although this "physiologic acidosis" is usually attributed to a limited capacity of the kidney to excrete the acid load imposed by diet (2), inadequate data during this period are avail-able to permit acceptance or rejection of this hypothesis.…”