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Review Open Access

Blood gas analysis: Clinical applications, interpretation and future directions (Review)

  • Authors:
    • Mercedes Núñez Sanagustín
    • Joško Osredkar
  • View Affiliations / Copyright

    Affiliations: Institute of Clinical Chemistry and Biochemistry, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
    Copyright: © Sanagustín et al. This is an open access article distributed under the terms of Creative Commons Attribution License [CC BY 4.0].
  • Article Number: 7
    |
    Published online on: December 16, 2025
       https://doi.org/10.3892/mi.2025.291
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Abstract

Blood gas analysis represents a cornerstone diagnostic method in clinical practice, providing rapid assessment of respiratory and metabolic status through evaluation of pH, partial pressure of oxygen, partial pressure of carbon dioxide and bicarbonate. The present comprehensive review discusses recent advances in blood gas analysis, including emerging artificial intelligence (AI) applications, controversial practices in venous vs. arterial sampling and closed‑loop management systems in critical care. The present review critically synthesizes evidence from recent systematic reviews and meta‑analyses, addressing key controversies, such as the clinical utility of venous blood gas analysis with venous‑to‑arterial conversion technology (sensitivity, 97.6%; specificity, 36.9% for respiratory failure diagnosis) and automated interpretation systems. The present review encompasses physiological foundations, evidence‑based clinical applications, structured interpretation methodologies and quality improvement strategies. Emphasis is placed on technological innovations including AI‑assisted interpretation, non‑invasive monitoring technologies and integration with closed‑loop therapeutic systems. Through the analysis of >50 recent publications and current guidelines, the present review aimed to provide evidence‑based recommendations for modern clinical practice, highlighting when venous sampling provides adequate diagnostic information, while reducing patient discomfort. Future perspectives include predictive algorithms for early clinical deterioration recognition and personalized diagnostic approaches. The present review aimed to provide unique clinical value by bridging traditional blood gas analysis with cutting‑edge technological applications, providing practitioners with contemporary, evidence‑based guidance for optimal patient care.
View Figures

Figure 1

Systematic ABG interpretation
flowchart using the CLEAR approach. ABG, arterial blood gas; CLEAR,
Check oxygenation, look at pH, evaluate compensation, assess anion
gap, and Review for mixed disorders; PaO2, partial
pressure of oxygen; PaCO2, partial pressure of carbon
dioxide.

Figure 2

Closed-loop blood gas management
algorithm in critical care. ICU, intensive care unit; ABG, arterial
blood gas; PaO2, partial pressure of oxygen;
PaCO2, partial pressure of carbon dioxide;
FiO2, fraction of inspired oxygen; PEEP, positive
end-expiratory pressure; RR, respiratory rate.

Figure 3

Real-time blood gas monitoring
integration protocol.
View References

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Spandidos Publications style
Sanagustín MN and Osredkar J: Blood gas analysis: Clinical applications, interpretation and future directions (Review). Med Int 6: 7, 2026.
APA
Sanagustín, M.N., & Osredkar, J. (2026). Blood gas analysis: Clinical applications, interpretation and future directions (Review). Medicine International, 6, 7. https://doi.org/10.3892/mi.2025.291
MLA
Sanagustín, M. N., Osredkar, J."Blood gas analysis: Clinical applications, interpretation and future directions (Review)". Medicine International 6.1 (2026): 7.
Chicago
Sanagustín, M. N., Osredkar, J."Blood gas analysis: Clinical applications, interpretation and future directions (Review)". Medicine International 6, no. 1 (2026): 7. https://doi.org/10.3892/mi.2025.291
Copy and paste a formatted citation
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Spandidos Publications style
Sanagustín MN and Osredkar J: Blood gas analysis: Clinical applications, interpretation and future directions (Review). Med Int 6: 7, 2026.
APA
Sanagustín, M.N., & Osredkar, J. (2026). Blood gas analysis: Clinical applications, interpretation and future directions (Review). Medicine International, 6, 7. https://doi.org/10.3892/mi.2025.291
MLA
Sanagustín, M. N., Osredkar, J."Blood gas analysis: Clinical applications, interpretation and future directions (Review)". Medicine International 6.1 (2026): 7.
Chicago
Sanagustín, M. N., Osredkar, J."Blood gas analysis: Clinical applications, interpretation and future directions (Review)". Medicine International 6, no. 1 (2026): 7. https://doi.org/10.3892/mi.2025.291
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