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Acid Base Disorders - Blood Gas Interpretation Steps for Blood Gas Interpretation: 1. Acidemia or Alkalemia? 2.
Acid Base Disorders ... 7.35-7.45 • PaCO2 ... 35-45 mmHg • PaO2 ... Metabolic: pH pCO2 ... #AcidBase #disorders
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
Acid-Base Disorders - Differential Diagnosis Algorithm Acidemia (pH < 7.35) • Metabolic Acidosis (HCO3 < 24mmol/L) CO2
Acid-Base Disorders ... • Metabolic Alkalosis ... • Respiratory Alkalosis ... (pCO2 < 35 mmHg ... #AcidBase #Disorders
Arterial Blood Gas (ABG) Analysis - Metabolic + Respiratory Acidosis + Alkalosis pH ↓ pCO2 ↓ -
Respiratory Acidosis + Alkalosis ... pH ↓ pCO2 ↓ ... ↑ - Metabolic alkalosis ... Respiratory alkalosis ... Compensation #acidosis #alkalosis
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%
Acid Base Disorders Worksheet Step 1: Gather the necessary data (Na+, CI-, HCO3-, PH, pCO2). Preferably, all
Acid Base Disorders ... has a primary alkalosis ... >40 patient's alkalosis ... is -Y patient's alkalosis ... Step 4: Look for disorders
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
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 ... (Patm - 47) - (PaCO2 ... /0.8)] - PaO2 Simplified ... /0.8)] - PaO2 Normal
Approach to Acid Base Disorders - Evaluation and Differential Diagnosis 1) Start with the Anion Gap (AG). 2)
Approach to Acid Base Disorders ... more acidotic or alkalotic ... and ~5 mmHg to pCO2 ... chronic) of the disorder ... #Acid #Base #Disorders
Acid-Base Disorders - Differential Diagnosis Framework • Respiratory Acidosis • Respiratory Alkalosis • Metabolic Acidosis •
Acid-Base Disorders ... • Respiratory Alkalosis ... • Metabolic Alkalosis ... AcidBase #Acid #Base #Disorders ... diagnosis #acidosis #alkalosis
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