BLOODGASESANDACID–BASEDISORDERS.pptVIP

BLOOD GASES ANDACID–BASE DISORDERS Professor Magdy Amin RIAD Professor of Otolaryngology. Ain shames University Senior Lecturer in Otolaryngology University of Dundee CAPILLARY BLOOD GASES pH: Same as arterial or slightly lower (Normal = 7.35-7.40) pCO2: Same as arterial or slightly higher (Normal = 40-45) pO2: Lower than arterial (Normal = 45-60) O2 Saturation: 70% is acceptable. CAPILLARY BLOOD GASES Saturation is probably more useful than the pO2 itself when interpreting a CBG. The heel is the most commonly used site The CBG is often used for pediatric patients because it is easier to obtain than the ABG less traumatic (no risk of arterial thrombosis, hemorrhage). blood gas machines The blood gas machines in most labs actually measure the pH ,the pCO2 and the pO2. The [HCO3-] and the base difference are calculated values using the Henderson-Hasselbalch equation For a rough estimate of [H+] [H+] = (7.80 -pH) x100. This is accurate from a pH 7.25 to 7.48; 40 mEq/L = [H+] at the normal pH of 7.40. pH is a log scale, and for every change of 0.3 in pH from 7.40 the [H+] doubles or halves. For pH 7.10 the [H+] = 2 x 40, or 80 nmol/L, and for pH 7.70 the [H+] = 1/2 x40, or 20 nmol/L. pCO2 and pH A change in pCO2 up or down 10 mm Hg is associated with an increase or decrease in pH of 0.08 units. As the pCO2 decreases, the pH increases; as the pCO2 increases, the pH decreases. base deficit and base excess A pH change of 0.15 is equivalent to a base change of 10 mEq/L. A decrease in base (i.e, [HCO3-]) is termed a base deficit, and an increase in base is termed a base excess. Acidosis and alkalosis Acid-base disorders are very common clinical problems. Acidemia is a pH 7.37, and alkalemia is a pH 7.44. Acidosis and alkalosis are used to describe how the pH changes. The primary causes of acid-base disturbances are abnormalities in the respiratory system and in the metabolic or renal system. normal compensatory response Any primary disturbance