Cheatography
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DefinitionsAcid | CO2; proton donor | Base | HCO3-; proton acceptor | Acidemia | pH < 7.35 | Alkalemia | pH > 7.45 | Acidosis | Process that results in decreased blood pH | Alkalosis | Process that results in increased blood pH | Respiratory regulation | Regulates CO2; compensation occurs in min to hrs | Renal regulation | Regulates HCO3-; compensation takes up to 1wk |
Consequences of AlkalemiaHypokalemia | Arteriolar constriction | Reduced coronary blood flow | Decreased plasma ionized [Ca] | Decreased Mg and PO4 | Reduced cerebral blood flow | Tetany, seizures |
Consequences of AcidemiaHyperkalemia | Impaired cardiac contractility | Reduced ATP synthesis | Impaired response to catecholamines | Reduced cardiac output | Insulin resistance | Coma |
Primary Disorders| | pH | PaCO2 | HCO3- | Respiratory Acidosis | decreased | increased | normal | Respiratory Alkalosis | increased | decreased | normal | Metabolic Acidosis | decreased | normal | decreased | Metabolic Alkalosis | increased | normal | increased |
Partially Compensated States| | pH | PaCO2 | HCO3- | Respiratory Acidosis | decreased | increased | increased | Respiratory Alkalosis | increased | decreased | decreased | Metabolic Acidosis | decreased | decreased | decreased | Metabolic Alkalosis | increased | increased | increased |
Fully Compensated States| | pH | PaCO2 | HCO3- | Respiratory Acidosis | Normal, but < 7.40 | increased | increased | Respiratory Alkalosis | Normal, but > 7.40 | decreased | decreased | Metabolic Acidosis | Normal, but < 7.40 | decreased | decreased | Metabolic Alkalosis | Normal, but > 7.40 | increased | increased |
| | Arterial Blood Gas RangespH | 7.35-7.45 | PaCO2 | 35-45mmHg | PaO2 | 80-100mmHg | HCO3- | 22-26 mEq/L | SaO2 | >95% |
Anion Gap (AG)Definition | Concentration of unmeasured anions in plasma | Unmeasured anions | Sulfates, phosphates, blood proteins such as albumin | Use | Determines type of metabolic acidosis | Equation | [Na+] - ([Cl-] + [HCO3-]) | Normal AG | 12 mEq/L; range of 8–16 acceptable | Elevated AG | >20 mEq/L | Metabolic alkalosis | Excess AG+HCO3 > normal HCO3- | Metabolic acidosis | Excess AG+HCO3 < normal HCO3- |
AG: Difference in electrical charge between cations and anions in blood. Causes of Elevated Anion GapMethanol | Uremia | Diabetic ketoacidosis | Propylene glycol | Isoniazid | Lactic acidosis | Ethylene glycol | Renal Failure |
Diagnosing Acid/Base Disorders1. Determine if patient is acidic or basic | 2. Determine if it is an anion gap acidosis (normally due to MUDPILER) | 3. Determine if metabolic alkalosis or non-anion gap acidosis |
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