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Acid Base Disorders - Blood Gas Interpretation Steps for Blood Gas Interpretation: 1. Acidemia or Alkalemia? 2.
7.35-7.45 • PaCO2 ... 35-45 mmHg • PaO2 ... Metabolic: pH pCO2 ... D-lactate (short bowel syndrome ... MDaniyalHashmi1 #AcidBase
Hypoxia and Hypoxemia - Overview Hypoxia - insufficient oxygen delivered to tissues to meet demands Hypoxemia - low
O2 is inspired) PAO2 ... reaches the alveoli) PaO2 ... Low SvO2 → Low PaO2 ... Low SvO2 → Low PaO2 ... sepsis) - High PaO2
Approach to the A-a Gradient A-a gradient = PAO2 - PaO2 A-a gradient = [FiO2 x (Patm -
A-a gradient = PAO2 ... - PaO2 A-a gradient ... /0.8)] - PaO2 Simplified ... Hypoventilation Syndrome ... Hepatopulmonary Syndrome
Markers of Organ Dysfunction in Severe Sepsis Altered consciousness Confusion Psychosis Tachycardia Hypotension Altered CVP Altered
Altered CVP Altered PAOP ... Tachypnoea PaO2 ... <70mmHg SaO2 < ... 90% PaO2/FiO2 300%
Arterial Blood Gas (ABG) Analysis - Metabolic + Respiratory Acidosis + Alkalosis pH ↓ pCO2 ↓ -
Alkalosis pH ↓ pCO2 ... acidosis pH ↑ pCO2 ... alkalosis pH ↑ pCO2 ... alkalosis pH ↓ pCO2 ... Interpretation #AcidBase
Perform computations online at: ScyMed.com 6th ED ICU-card «ICU, Formulas & Drugs» HEMODYNAMIC PATTERNS Condition SAP CVP PAP PCWP CO C(a-v)02 PVR SVR Hypovolemic shock ↓ ↓ ↓ ↓ ↓ ↑ ↑ ↑ Cardiogenic shock ↓ 1 ↑ 1 1 ↑ Septic shock ↓ ↓ ↓ ↓ ↑ ↓ ↓ ↓ Cardiac Tamponade . ↑ ↑ 1 ↓ → ↑ RV
-PECO2))/PaCO2 ... age-corrected PAO2 ... /R) | Pa02 80- ... ))+(Pa02*0.0031) ... )-(CvO2) Pa02
Acid Base Compensation - Directions - If all three variables (pH, HCO2, pCO2) move in the
variables (pH, HCO2, pCO2 ... Diagnosis #Nephro #AcidBase
PLACO Mnemonic - Approach to Acid-Base Disorders P - Determine the pH L - Labs: PCO2 & HCO3 A
pH L - Labs: PCO2 ... jadav_md #PLACO #AcidBase
Acid-Base Disorders - Differential Diagnosis Algorithm Acidemia (pH < 7.35) • Metabolic Acidosis (HCO3 < 24mmol/L) CO2
Respiratory Acidosis (pCO2 ... Respiratory Alkalosis (pCO2 ... < 35 mmHg) #AcidBase
Hepatopulmonary Syndrome HPS - Diagnosis: 1. Patients with liver disease 2. Alveolar-arterial oxygen gradient (AaP02) >15 mmHg
Hepatopulmonary Syndrome ... Moderate HPS: ≥ 60 PaO2 ... Severe HPS: ≥ 50 PaO2 ... Very severe HPS: PaO2 ... Hepatopulmonary #Syndrome
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