acid base balance (5 steps in diagnosis)
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acid base balance (5 steps in diagnosis)TRANSCRIPT
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Dr. Zahoor Ahmad
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1. Is the pH normal? 2. Is the CO2 normal? 3. Is the HCO3 normal? 4. Match the CO2 or the HCO3 with
pH5. Does the CO2 or the HCO3 go the
opposite direction of the pH?
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Normal pH 7.36-7.44pH< 7.36 AcidosispH > 7.44 Alkalosis
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Normal CO2 36‐45mmHgCO2 > 44mmHg Acidotic level CO2 < 36mmHg alkalotic level
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Normal HCO3 22 ‐26mmHgHCO3 < 22mmHg Acidotic level HCO3 > 26mmHg alkalotic level
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If pH and CO2 match each other, then primary acid-base abnormality is respiratory.
If pH and HCO3 match each other, then primary acid-base abnormality is Metabolic.
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(a)CO2 acidoticpH acidotic
Then primary acid-base balance???
(b)CO2 alkaloticpH alkaline
Then primary acid-base balance???
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(a)Respiratory acidosis
(b)Respiratory alkalosis
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(a)HCO3 acidoticpH acidotic
Then primary acid-base balance???
(b)HCO3 alkaloticpH alkaline
Then primary acid-base balance???
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(a)Metabolic acidosis
(b)Metabolic alkalosis
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Does either the CO2 or HCO3 go in opposite direction of pH? If so, there is compensation by the system.
pH acidoticCO2 acidoticHCO3 alkalotic
What is acid-base balance?????????
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Respiratory acidosis with
metabolic compensation
(Respiratory acidosis with metabolic compensation)
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pH alkaloticCO2 alkaloticHCO3 acidotic
What is acid-base balance?????????
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Respiratory alkalosis with
metabolic compensation
(Respiratory alkalosis with metabolic compensation)
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HCO3 alkaloticpH alkaloticCO2 acidotic
What is acid-base balance?????????
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Metabolic alkalosis with
Respiratory compensation
(Metabolic alkalosis with Respiratory acidosis)
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HCO3 acidosispH acidosisCO2 alkalosis
What is acid-base balance?????????
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Metabolic acidosis with
Respiratory compensation
(Metabolic acidosis with Respiratory compensation)
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Test Normal ↓ Value ↑ Value pH 7.35-7.45 Acidosis Alkalosis pCO 2 35-45 Alkalosis Acidosis HCO 3 22-26 Acidosis Alkalosis
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pH 7.52CO2 29HCO3 23
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pH 7.18CO2 44HCO3 23
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pH 7.60CO2 37HCO3 35
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pH 7.30CO2 30HCO3 14
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Complete compensation returns the pH normal.
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Thank You