Acid-Base Profiling

Question 1

List blood gas parameters

-Measured vs calculated

Answer 1

Measure

• pCO2 (which closely correlates with H2CO3)
• pO2
• pH
• TCO2 (reasonable estimate of bicarb)

Calculated
-HCO3-

Question 2

Relationship TCO2 & HCO3

Answer 2

TCO2 = total CO2 released during acid titration
-estimates bicarb

HCO3 = bicarb

• always a few values diff from TCO2
• more accurate measure ?

Question 3

What are the Blood gas parameters that are primarily associated with Metabolic disorders?

Answer 3

TCO2

Kidney

Question 4

What are the Blood gas parameters that are primarily associated with Respiratory disorders?

Answer 4

pCO2

Lungs

Question 5

If there is a Compensation, the blood gas abnormalities move in ……. direction

Answer 5

..the SAME..

bc the body is trying to maintain the 20:1 ratio (which maintains the pH)

Question 6

Examples of conditions that lead to RESPIRATORY ACIDOSIS

Answer 6

Increased pCO2 = Decreased ventilation

1. Anesthesia
   
   • -suppression of medulla
2. CNS dz
3. SEVERE pulmonary Dz
   
   • • CO2 exchange must also be compromised

Question 7

Examples of conditions that lead to METABOLIC ACIDOSIS

Answer 7

Decreased Bicarb

1. Titrational
   
   • increased anions
2. Secretional/ loss
   
   • GI
   • Kidney

Question 8

Examples of conditions that lead to RESPIRATORY ALKALOSIS

Answer 8

Decreased pCO2 = Increases ventilation

1. Fear/ pain
   
   • assuming exchange is taking place
2. Heat stroke
3. Moderate Pulmonary Dz
   
   • P trying to get >O2, but CO2 is diffusing better
4. Iatrogenic
   
   • Sx bagging

Question 9

Examples of conditions that lead to METABOLIC ALKALOSIS

Answer 9

Increased Bicarb

1. H+ loss
   
   • Renal Loss
   • GI sequestration
2. Iatrogenic
3. HypoKalemia w/ dehydration

Question 10

What is the ratio the body needs to maintain, in order to have a balanced pH

Answer 10

Bicarb (20) : H2CO3 (1) = pH 7.4

Metabolic : Lungs