Blood Gases, ph, Acid- Base Balance
|
|
- Tracy Tyler
- 6 years ago
- Views:
Transcription
1 Blood Gases, ph, Acid- Base Balance Blood Gases Acid-Base Physiology Clinical Acid-Base Disturbances Blood Gases Respiratory Gas Exchange Chemical Control of Respiration Dyshemoglobins Oxygen Transport Oxygen Saturation Effects of Acid on Oxygen Transport Carbon Dioxide Transport Chloride Shift 1
2 Respiratory Gas Exchange Respiratory Gas Exchange External respiration: exchange of O 2 & CO 2 in lungs between alveolar air & blood Internal respiration: occurring at tissue level; consumes O 2 & produces CO 2 & organic acid metabolites 2
3 Pulmonary Capillary Gas Exchange A. Oxygen B. Carbon Dioxide Respiratory Processes & Partial Pressures in Respiration 3
4 Chemical Control of Respiration Respiratory control centers In brain stem (medulla) Chemoreceptors control centers In aortic & carotid bodies Control by: Sensitive to changes in [H + ], arterial pco 2 & po 2 Alter pulmonary ventilation Increased temperatures also accelerate the respiratory rate Dyshemoglobins: malfunction; an alteration in their binding sites. Carboxyhemoglobin (COHb) - Hb binds with carbon monoxide (CO) Carbon monoxide has ~200 times the affinity for Hb than does O 2 Methemoglobin (MetHb) - ferrous ion (Fe ++ ) oxidizes to ferric state (Fe +++ ) Fetal hemoglobin (HbF) 4
5 Oxygen Transport reversibly bound to hemoglobin in erythrocytes (O 2 Hb) dissolved O 2 (do2) in erythrocytes & plasma Blood Oxygen Saturation Spectrophotometric methods SO 2 = Methemoglobinemia / CO Poisoning SO 2 = Hb tot = HbO 2, HHb, COHb, MetHb, SulfHb, or cyanmethemoglobin 5
6 Determination of Oxygen Saturation by Spectrophotometry 鮮紅的血 暗紅的血 A short light-path cuvet: 0.1-mm light-path Reference Values Oxygen content of arterial blood in normal person ~20 ml/dl Arterial Oxygen Saturation 95 to 98% saturated with Oxygen 6
7 Oxygen dissociation curve under normal conditions Myoglobin is more highly saturated with oxygen at lower partial pressures of oxygen than is the hemoglobin molecule 7
8 ph & the affinity of Hb for oxygen Oxyhemoglobin Dissociation Curve (OHDC) causing a decreased affinity (a right shift) acidosis hyperthermia (fever) hypercarbia (increased PCO 2 ) increased 2,3 DPG (an organophosphate that exists as an intermediate of glycolysis) 8
9 Oxyhemoglobin Dissociation Curve (OHDC) causing an increased affinity (a left shift) alkalosis hypothermia hypocarbia decreased 2,3 DPG what happens when the curve is shifted 9
10 Figure 3.15 Causes & Mechanisms of Hypoxaemia 缺氧 Carbon Dioxide Transport a small amount is dissolved in liquid portion of blood (plasma) a small amount binds with hemoglobin to form carboxyhemoglobin (CO2HB) majority of carbon dioxide travels as bicarbonate ion (HCO3-) 10
11 Transport of carbon dioxide 11
12 Chloride Shift: as a red cell passes through lungs, it loses Cl - to plasma HCO 3 - RBC CO 2 CO 2 plasma 12
13 Determination of Serum CO 2 Content (Total CO 2 ) Automated enzymatic method All forms of CO 2 are converted to HCO 3 - Addition of base Automated colorimetric method Addition of acid All forms are converted to CO 2 Dialyzed through a silicone-rubber gas-dialysis membrane Into a buffer solution of cresol red at ph 9.2 Lower ph & decrease in color intensity (430 nm) Methods for Determination of Serum or Plasma Total Carbon Dioxide Sample first alkalinized to convert all forms of CO 2 to HCO 3 - PEPC: phosphoenolpyruvate carboxylase MDH: malate dehydrogenase Decrease in A 340 nm of NADH proportional to total CO 2 content 13
14 Determination by pco2 electrode Reference values 22 to 30 mmol/l for health adults 14 to 26 mmol/l in premature newborns 20 to 26 mmol/l for infants Determination by pco2 electrode Increased concentration (hypercapnia) Metabolic alkalosis, compensated respiratory acidosis & frequently alkalosis accompanying a large potassium deficiency Decreased concentration (hypocapnia) Metabolic acidosis & compensated respiratory alkalosis 14
15 BLOOD GASES: Collection of blood Arterial Blood Whenever po 2 measurement is requested Arterialized Venous Blood Heating hand & forearm in water at 45 C for 5 min Arterialized Capillary Blood: infants Warming ear, finger, or heel at 45 C before taking sample Arterial Sampling Sites 15
16 Blood-gas Instrumentation ph, pco 2, & po 2 are made stimultaneously E 1 is po 2, E 2 pco 2, E 3 is ph, and E 4 is the reference for ph Normal Ranges of Laboratory Values Factor ph PaO 2 (mmhg) Mean Range PaCO 2 (mmhg) HCO 3 - (meq/l)
17 Effects of temperature Normally assess blood gases at 37 o C Which reduces the PCO 2 by about 4.5% per o C The ph rises about per o C Any exposure to air: po 2 and pco 2, ph Acid-Base Physiology Acids and ph Acid Buffering Acid-Base Balance Acid-Base disturbances 17
18 ph (puissance Hydrogen) ph= -log [H + ] Normal ph in human body is between Blood ph Some abnormal conditions: e.g. lactic acidosis & diabetes mellitus Lactic acid, β-hydroxybutyric acid, and acetoacetic acid may accumulate Transported to excretory organs (lungs & kidneys) Minimal change in plasma ph Blood Buffer Systems 18
19 Buffer in the Blood A buffer is any substance that can reversibly bind hydrogen ions General form of buffering reaction is: Blood Buffer Systems Blood Urine Bicarbonate/carbonic acid buffer system Protein Buffer system Hemoglobin buffer system Plasma protein buffer (albumin) Phosphate buffer system Ammonia buffer system 19
20 Bicarbonate/carbonic acid Buffer System Most important buffer of plasma 95% of buffering capacity kidney Recover or not lung pulmonary ventilation Bicarbonate/carbonic acid Buffer System lung kidney 20
21 Henderson-Hasselbalch Equation ph = pk + log(hco 3 - / H 2 CO 3 ) or ph = pk + log(hco 3 - / 0.03 x PCO 2 ) 0.03 is solubility coefficient for carbon dioxide & pk is a constant whose value is 6.1 A normal value for bicarbonate = 24 meq/l & for carbon dioxide = 40mmHg Therefore, ph = log[24 /( 0.03 x 40)] or ph = log (24 / 1.2) = log 20 or ph = or ph = 7.4 Proteins Buffers System - High concentration - Very important Hemoglobin buffer system Plasma protein buffer system albumin 21
22 Hemoglobin Buffer System Hemoglobin Buffer System Major part of buffering capacity of erythrocytes Most important buffer groups: imidazole groups 22
23 PLASM PROTEIN BUFFER SYSTEM Albumin account for 95% nonbicarbonate buffer value of plasma Most important buffer groups: imidazole groups of histidines + H + pk = His / albumin Phosphate Buffer System H 2 PO 4 H + + HPO 4 2- In plasma (ph 7.4), 80% phosphate is in HPO 4 2- form NOT important in blood; low concentration ~5% nonbicarbonate buffer value Plays a role in buffering intracellular and tubular fluid In acid urine, it exists as H 2 PO 4 - Important; 90% 23
24 Buffering of hydrogen ion in urine Excreted H+ must be buffered in urine Otherwise [H+] would rise to very high levels Phosphate buffer Ammonia buffer Renal Compensatory Mechanism Na+-H+ exchange Excretion of acids Excretion of H+ as H2PO4 Production of ammonia (NH3) & excretion of ammonium ions (NH4+) Reclamation of filtered bicarbonate 24
25 Renal Compensatory Mechanism H + + HPO 4 2- => H 2 PO 4 - Renal Mechanisms 25
26 Bicarbonate Reabsorption New Bicarbonate 26
27 Recovery & regeneration of bicarbonate by excretion of H+ in the renal tubular cell H+ is actively secreted into urine while CO2 diffuses along its concentration gradient Recovery of bicarbonate Regeneration of bicarbonate - excretion of hydrogen ion Clinical Acid-Base Disturbances Approach to the Abnormal Blood Gas Metabolic Acidosis Metabolic Alkalosis Respiratory Acidosis Respiratory Alkalosis Therapy of Respiratory Acidosis Therapy of Metabolic Acidosis 27
28 Nomenclature Physiologic condition Acidosis Alkalosis Hypoxia Hyperoxia Alveolar Hyperventilation Ventilatory Failure Values ph <7.35 ph >7.45 PaO 2 <60 PaO 2 >100 PaCO 2 <35 PaCO 2 >50 Primary Blood Gas Classifications Classification ph PaCO 2 HCO 3 - Acute metabolic acidosis N Chronic metabolic acidosis N Acute metabolic alkalosis N Chronic metabolic alkalosis N Primary change 28
29 H + Metabolic Acidosis H + ph HCO 3- CO 2 Respiratory Compensation ph = pk + log(hco 3 - / 0.03 x PCO 2 ) 29
30 Hyperventilation CO 2 Effect of hyperventilation Basic Causes of Abnormalities Metabolic acidoses: a. ketoacidoses (diabetic/alcoholic) b. renal failure c. lactic acidosis d. rhabdomyolysis e. toxins (methanol, ethylene glycol, salicylates, paraldehyde) f. diarrhea g. HCl administration 30
31 HCO 3- H +, ph (HCO 3- ) CO 2 ph = pk + log HCO 3 - / 0.03 x PCO 2 Metabolic Alkalosis 31
32 Hypoventilation CO 2 Respiratory Compensation Basic Causes of Abnormalities Metabolic alkaloses: a. vomiting/ NG suctioning b. diuretic therapy c. mineralocorticoid activity (Cushing's syndrome, exogenous steroids) 32
33 Acid-base disorders: diagnosis & management Reasons for metabolic acidosis & alkalosis 33
34 結果分析 Primary Blood Gas Classifications Classification Acute ventilatory failure (acute respiratory acidosis) Chronic ventilatory failure (compensated respiratory acidosis) Acute alveolar hyperventilation (acute respiratory alkalosis) Chronic alveolar hyperventilation (compensated respiratory alkalosis) Primary change 代償 ph PaCO2 HCO3 N N N N 34
35 :Hypoventilation CO 2 ph ph = pk + log HCO 3 - / 0.03 x PCO 2 Respiratory Acidosis ph = pk + log HCO 3 - / 0.03 x PCO 2 RENAL COMPENSATION 3 Excretion of acids Reclamation of filtered bicarbonate 35
36 Basic Causes of Abnormalities Acute ventilatory failure: a. acute airway obstruction b. severe pneumonia/pulmonary edema c. neuromuscular disorders d. CNS depression (drugs, CNS event) e. ventilator dysfunction Chronic ventilatory failure: a. chronic lung diseases 36
37 Respiratory Alkalosis : Hyperventilation CO 2 ph ph = pk + log HCO 3 - / 0.03 x PCO 2 RENAL COMPENSATION Excretion of bicarbonate RENAL COMPENSATION 37
38 Basic Causes of Abnormalities Acute alveolar hyperventilation: a. Anxiety b. hypoxia c. drugs (aspirin, catecholamines, progesterone) d. Sepsis e. hepatic encephalopathy ( ) Causes of respiratory acidosis & alkalosis 38
39 39
Arterial Blood Gas Analysis
Arterial Blood Gas Analysis L Lester www.3bv.org Bones, Brains & Blood Vessels Drawn from radial or femoral arteries. Invasive procedure Caution must be taken with patient on anticoagulants ph: 7.35-7.45
More informationAcid-Base Tutorial 2/10/2014. Overview. Physiology (2) Physiology (1)
Overview Acid-Base Tutorial Nicola Barlow Physiology Buffering systems Control mechanisms Laboratory assessment of acid-base Disorders of H + ion homeostasis Respiratory acidosis Metabolic acidosis Respiratory
More informationCarbon Dioxide Transport. Carbon Dioxide. Carbon Dioxide Transport. Carbon Dioxide Transport - Plasma. Hydrolysis of Water
Module H: Carbon Dioxide Transport Beachey Ch 9 & 10 Egan pp. 244-246, 281-284 Carbon Dioxide Transport At the end of today s session you will be able to : Describe the relationship free hydrogen ions
More informationFluid and Electrolytes P A R T 4
Fluid and Electrolytes P A R T 4 Mechanisms that control acid-base homeostasis Acids and bases continually enter and leave body Hydrogen ions also result from metabolic activity Acids Hydrogen ion donors
More information3. Which of the following would be inconsistent with respiratory alkalosis? A. ph = 7.57 B. PaCO = 30 mm Hg C. ph = 7.63 D.
Pilbeam: Mechanical Ventilation, 4 th Edition Test Bank Chapter 1: Oxygenation and Acid-Base Evaluation MULTIPLE CHOICE 1. The diffusion of carbon dioxide across the alveolar capillary membrane is. A.
More informationAcids, Bases, and Salts
Acid / Base Balance Objectives Define an acid, a base, and the measure of ph. Discuss acid/base balance, the effects of acidosis or alkalosis on the body, and the mechanisms in place to maintain balance
More informationPhysiological Causes of Abnormal ABG s
Physiological Causes of Abnormal ABG s Major Student Performance Objective 1 1. The student will be able to discuss causes for various types of blood gas results. 2. They will also be required to discuss
More informationAcid and Base Balance
Acid and Base Balance 1 2 The Body and ph Homeostasis of ph is tightly controlled Extracellular fluid = 7.4 Blood = 7.35 7.45 < 7.35: Acidosis (acidemia) > 7.45: Alkalosis (alkalemia) < 6.8 or > 8.0: death
More informationUNIT 9 INVESTIGATION OF ACID-BASE DISTURBANCES
UNIT 9 INVESTIGATION OF ACIDBASE DISTURBANCES LEARNING OBJECTIVES At the end of this chapter, students must be able to: 1. Describe the main parametres that define the acidbase equilibrium 2. Identify
More informationAcid - base equilibrium
Acid base equilibrium ph concept ph = log [H + ] ph [H+] 1 100 mmol/l D = 90 mmol/l 2 10 mmol/l D = 9 mmol/l 3 1 mmol/l 2 ph = log [H + ] 3 ph ph = log [H + ] ph of capillary blood norm: 7,35 7,45 Sorensen
More informationDr. Suzana Voiculescu
Dr. Suzana Voiculescu AB balance parameters Extracellular ph (plasmatic ph)= 7.35-7.45 < 7.35= acidosis >7.45= alkalosis Kassirer-Bleich equation [H+] = 24 PCO2/ [HCO3-] predicts that the ratio of dissolved
More informationARTERIAL BLOOD GASES PART 1 BACK TO BASICS SSR OLIVIA ELSWORTH SEPT 2017
ARTERIAL BLOOD GASES PART 1 BACK TO BASICS SSR OLIVIA ELSWORTH SEPT 2017 WHAT INFORMATION DOES AN ABG GIVE US? ph = measure of hydrogen ion concentration (acidity or alkalinity) PaCO2 = partial pressure
More informationRESPIRATORY SYSTEM and ACID BASE
RESPIRATORY SYSTEM and ACID BASE Arif HM Marsaban Rudyanto Sedono Department of Anesthesiology and Intensive Therapy Faculty of medicine University of Indonesia Dr Cipto Mangunkusumo General Hospital Jakarta
More informationD fini n tion: p = = -log [H+] ph=7 me m an s 10-7 Mol M H+ + (100 nmol m /l); ) p ; H=8 me m an s 10-8 Mol M H+ + (10 (10 n nmol m /l) Nor
Definition: ph regulation ph = -log [H + ] ph=7 means 10-7 Mol H + (100 nmol/l); ph=8 means 10 Normal plasma value: 7.35-7.45; 7.45; (H Acidosis: ph7.45 Intracellular ph = 7.1-7.3
More informationUNIT VI: ACID BASE IMBALANCE
UNIT VI: ACID BASE IMBALANCE 1 Objectives: Review the physiological mechanism responsible to regulate acid base balance in the body i.e.: Buffers (phosphate, hemoglobin, carbonate) Renal mechanism Respiratory
More informationRenal Physiology. April, J. Mohan, PhD. Lecturer, Physiology Unit, Faculty of Medical Sciences, U.W.I., St Augustine.
Renal Physiology April, 2011 J. Mohan, PhD. Lecturer, Physiology Unit, Faculty of Medical Sciences, U.W.I., St Augustine. Office : Room 105, Physiology Unit. References: Koeppen B.E. & Stanton B.A. (2010).
More informationControl of Ventilation [2]
Control of Ventilation [2] สรช ย ศร ส มะ พบ., Ph.D. ภาคว ชาสร รว ทยา คณะแพทยศาสตร ศ ร ราชพยาบาล มหาว ทยาล ยมห ดล Describe the effects of alterations in chemical stimuli, their mechanisms and response to
More informationThere are number of parameters which are measured: ph Oxygen (O 2 ) Carbon Dioxide (CO 2 ) Bicarbonate (HCO 3 -) AaDO 2 O 2 Content O 2 Saturation
Arterial Blood Gases (ABG) A blood gas is exactly that...it measures the dissolved gases in your bloodstream. This provides one of the best measurements of what is known as the acid-base balance. The body
More informationAcids and Bases their definitions and meanings
Acids and Bases their definitions and meanings Molecules containing hydrogen atoms that can release hydrogen ions in solutions are referred to as acids. (HCl H + Cl ) (H 2 CO 3 H + HCO 3 ) A base is an
More informationBUFFERING OF HYDROGEN LOAD
BUFFERING OF HYDROGEN LOAD 1. Extracellular space minutes 2. Intracellular space minutes to hours 3. Respiratory compensation 6 to 12 hours 4. Renal compensation hours, up to 2-3 days RENAL HYDROGEN SECRETION
More informationSlide 1. Slide 2. Slide 3. Learning Outcomes. Acid base terminology ARTERIAL BLOOD GAS INTERPRETATION
Slide 1 ARTERIAL BLOOD GAS INTERPRETATION David O Neill MSc BSc RN NMP FHEA Associate Lecturer (Non Medical Prescribing) Cardiff University Advanced Nurse Practitioner Respiratory Medicine Slide 2 Learning
More informationInterpretation of Arterial Blood Gases. Prof. Dr. W. Vincken Head Respiratory Division Academisch Ziekenhuis Vrije Universiteit Brussel (AZ VUB)
Interpretation of Arterial Blood Gases Prof. Dr. W. Vincken Head Respiratory Division Academisch Ziekenhuis Vrije Universiteit Brussel (AZ VUB) Before interpretation of ABG Make/Take note of Correct puncture
More informationBiochemistry of acid-base disorders. Alice Skoumalová
Biochemistry of acid-base disorders Alice Skoumalová Main topics of the lecture: Measurement of acid-base dysbalance Classification of the acid-base disorders 4 basic acid-base disorders and their compensaiton
More informationAcid Base Balance. Professor Dr. Raid M. H. Al-Salih. Clinical Chemistry Professor Dr. Raid M. H. Al-Salih
Acid Base Balance 1 HYDROGEN ION CONCENTRATION and CONCEPT OF ph Blood hydrogen ion concentration (abbreviated [H + ]) is maintained within tight limits in health, with the normal concentration being between
More informationOxygen and CO 2 transport. Biochemistry II
Oxygen and CO 2 transport 2 Acid- base balance Biochemistry II Lecture 9 2008 (J.S.) 1 Transport of O 2 and CO 2 O 2 INSPIRED AIR CO 2 EXPIRED AIR HCO 3 + HHb + Lungs HbO 2 + H + + HCO 3 HbO 2 + H 2 O
More informationDr. Suzana Voiculescu Discipline of Physiology and Fundamental Neurosciences Carol Davila Univ. of Medicine and Pharmacy
Dr. Suzana Voiculescu Discipline of Physiology and Fundamental Neurosciences Carol Davila Univ. of Medicine and Pharmacy AB balance parameters Extracellular ph (plasmatic ph)= 7.35-7.45 < 7.35= acidosis
More informationRespiratory Physiology Part II. Bio 219 Napa Valley College Dr. Adam Ross
Respiratory Physiology Part II Bio 219 Napa Valley College Dr. Adam Ross Gas exchange Gas exchange in the lungs (to capillaries) occurs by diffusion across respiratory membrane due to differences in partial
More informationChapter 15 Fluid and Acid-Base Balance
Chapter 15 Fluid and Acid-Base Balance by Dr. Jay M. Templin Brooks/Cole - Thomson Learning Fluid Balance Water constitutes ~60% of body weight. All cells and tissues are surrounded by an aqueous environment.
More informationRenal physiology V. Regulation of acid-base balance. Dr Alida Koorts BMS
Renal physiology V Regulation of acidbase balance Dr Alida Koorts BMS 712 012 319 2921 akoorts@medic.up.ac.za Hydrogen ions (H + ): Concentration and origin Concentration in arterial blood, resting: [H
More informationArterial Blood Gas Interpretation: The Basics
http://www.medicine-on-line.com ABG Basics: Page 1/10 Arterial Blood Gas Interpretation: The Basics Author: David C Chung MD, FRCPC Affiliation: The Chinese University of Hong Kong Sampling of arterial
More informationGas Exchange in the Tissues
Gas Exchange in the Tissues As the systemic arterial blood enters capillaries throughout the body, it is separated from the interstitial fluid by only the thin capillary wall, which is highly permeable
More informationBasic facts repetition Regulation of A-B balance. Pathophysiology of clinically important disorders
In The name of God Acid base balance Basic facts repetition Regulation of A-B balance Pathophysiology of clinically important disorders Acid-Base Balance Physiology - The ph of ECF is tightly regulated
More informationAcid-Base Imbalance-2 Lecture 9 (12/4/2015) Yanal A. Shafagoj MD. PhD
AcidBase Imbalance2 Lecture 9 (12/4/2015) Yanal A. Shafagoj MD. PhD Introduction Disturbance in acidbase balance are common clinical problem that range in severity from mild to life threatening, the acute
More informationAcid-Base 1, 2, and 3 Linda Costanzo, Ph.D.
Acid-Base 1, 2, and 3 Linda Costanzo, Ph.D. OBJECTIVES: After studying this lecture, the student should understand: 1. The relationship between hydrogen ion concentration and ph. 2. Production of acid
More informationCarbon Dioxide Transport and Acid-Base Balance
CHAPTER 7 Carbon Dioxide Transport and Acid-Base Balance Carbon Dioxide Transport Dioxide Transport In plasma: Carbamino compound (bound to protein) Bicarbonate Dissolved CO 2 CO 2 Is Converted to HCO
More informationThere are many buffers in the kidney, but the main one is the phosphate buffer.
9 Yanal Obada Zalat Renal Control of AcidBase Balance The kidneys play three major roles in the maintenance of normal acidbase balance: 1excretion of H+ (fixed _non volatile H+) 2Reabsorption of filtrated
More informationAcid-base balance is one of the most important of the body s homeostatic mechanisms Acid-base balance refers to regulation of hydrogen ion (H + )
Acid-base balance is one of the most important of the body s homeostatic mechanisms Acid-base balance refers to regulation of hydrogen ion (H + ) concentration in body fluids Precise regulation of ph at
More informationThe equilibrium between basis and acid can be calculated and termed as the equilibrium constant = Ka. (sometimes referred as the dissociation constant
Acid base balance Dobroslav Hájek dhajek@med.muni.cz May 2004 The equilibrium between basis and acid can be calculated and termed as the equilibrium constant = Ka. (sometimes referred as the dissociation
More informationCASE 27. What is the response of the kidney to metabolic acidosis? What is the response of the kidney to a respiratory alkalosis?
CASE 27 A 21-year-old man with insulin-dependent diabetes presents to the emergency center with mental status changes, nausea, vomiting, abdominal pain, and rapid respirations. On examination, the patient
More informationAcid-Base Balance Dr. Gary Mumaugh
Acid-Base Balance Dr. Gary Mumaugh Introduction Acid-base balance is one of the most important of the body s homeostatic mechanisms Acid-base balance refers to regulation of hydrogen ion (H + ) concentration
More informationNeaam Al-Bahadili. Rana J. Rahhal. Mamoun Ahram
5 Neaam Al-Bahadili Rana J. Rahhal Mamoun Ahram In this sheet we will continue taking about Titration curve and Buffers in human body. Let s begin Titration curve of phosphate buffer: 1. There are 3 buffering
More information1. What is the acid-base disturbance in this patient?
/ABG QUIZ QUIZ 1. What is the acid-base disturbance in this patient? Presenting complaint: pneumonia 1 point Uncompensated metabolic alkalosis Partially compensated respiratory alkalosis Mixed alkalosis
More informationNeaam Al-Bahadili. Rana J. Rahhal. Mamoun Ahram
5 Neaam Al-Bahadili Rana J. Rahhal Mamoun Ahram In this sheet we will continue taking about Titration curve and Buffers in human body. Let s begin Titration curve of phosphate buffer: 1. There are 3 buffering
More informationObjectives. Blood Buffers. Definitions. Strong/Weak Acids. Fixed (Non-Volatile) Acids. Module H Malley pages
Blood Buffers Module H Malley pages 120-126 Objectives Define a buffer system and differentiate between the buffering systems present in the body. Given an arterial blood-gas result, determine the degree
More information3/17/2017. Acid-Base Disturbances. Goal. Eric Magaña, M.D. Presbyterian Medical Center Department of Pulmonary and Critical Care Medicine
Acid-Base Disturbances Eric Magaña, M.D. Presbyterian Medical Center Department of Pulmonary and Critical Care Medicine Goal Provide an approach to determine complex acid-base disorders Discuss the approach
More informationAcid Base Balance. Chapter 26 Balance. ph Imbalances. Acid Base Balance. CO 2 and ph. Carbonic Acid. Part 2. Acid/Base Balance
Acid Base Balance Chapter 26 Balance Part 2. Acid/Base Balance Precisely balances production and loss of hydrogen ions (ph) The body generates acids during normal metabolism, tends to reduce ph Kidneys:
More information9/14/2017. Acid-Base Disturbances. Goal. Provide an approach to determine complex acid-base disorders
Acid-Base Disturbances NCNP October 10, 2017 Eric Magaña, M.D. Presbyterian Medical Center Department of Pulmonary and Critical Care Medicine Goal Provide an approach to determine complex acid-base disorders
More informationModule G: Oxygen Transport. Oxygen Transport. Dissolved Oxygen. Combined Oxygen. Topics to Cover
Topics to Cover Module G: Oxygen Transport Oxygen Transport Oxygen Dissociation Curve Oxygen Transport Studies Tissue Hypoxia Cyanosis Polycythemia Oxygen Transport Oxygen is carried from the lungs to
More informationDr. Suzana Voiculescu Discipline of Physiology and Fundamental Neurosciences Carol Davila Univ. of Medicine and Pharmacy
Dr. Suzana Voiculescu Discipline of Physiology and Fundamental Neurosciences Carol Davila Univ. of Medicine and Pharmacy Definition All the processes inside the body which keep the H+ concentration within
More informationAcid-Base Physiology. Dr. Tamás Bense Dr. Alexandra Turi
Acid-Base Physiology Dr. Tamás Bense Dr. Alexandra Turi What is a blood gas assessment? We get it from an arterial sample (a.radialis, a. brachialis, a. femoralis) Invasive technique If the patient is
More informationAcid/Base Balance. the concentrations of these two ions affect the acidity or alkalinity of body fluids
Acid/Base Balance some of most critical ions in body fluids are H + (hydrogen) and OH - (hydroxyl) ions the concentrations of these two ions affect the acidity or alkalinity of body fluids acidity/alkalinity
More informationDisorders of Acid-Base
Disorders of Acid-Base Balance Bởi: OpenStaxCollege Normal arterial blood ph is restricted to a very narrow range of 7.35 to 7.45. A person who has a blood ph below 7.35 is considered to be in acidosis
More informationDr. Suzana Voiculescu
Dr. Suzana Voiculescu Definition All the processes inside the body which keep the H+ concentration within normal values. Depends on water and ion balance blood gas homeostasis Blood acidity may be expressed
More informationAcid-Base Balance 11/18/2011. Regulation of Potassium Balance. Regulation of Potassium Balance. Regulatory Site: Cortical Collecting Ducts.
Influence of Other Hormones on Sodium Balance Acid-Base Balance Estrogens: Enhance NaCl reabsorption by renal tubules May cause water retention during menstrual cycles Are responsible for edema during
More informationAcid-Base Balance * OpenStax
OpenStax-CNX module: m46409 1 Acid-Base Balance * OpenStax This work is produced by OpenStax-CNX and licensed under the Creative Commons Attribution License 3.0 By the end of this section, you will be
More information/ABG. It covers acid-base disturbance, respiratory failure, and a small summary for some other derangements. Causes of disturbance
/ABG This page focuses on providing some possible causes for the various disturbances that may be seen on an ABG. Although not an exhaustive list, it attempts to outline the main headings for possible
More informationmmol.l -1 H+ Ca++ K+ Na+
Disorders of acid-base equilibrium Pathobiochemistry and diagnostics of acid-base and mineral metabolism Physiologic ph Plasma and most extracellular fluids ph = 7.40 ± 0.02 Significance of constant ph
More informationPBL SEMINAR. HEMOGLOBIN, O 2 -TRANSPORT and CYANOSIS An Overview
1 University of Papua New Guinea School of Medicine and Health Sciences Division of Basic Medical Sciences Discipline of Biochemistry and Molecular Biology PBL SEMINAR HEMOGLOBIN, O 2 -TRANSPORT and CYANOSIS
More informationAcid-Base disturbances Physiological approach
AcidBase disturbances Physiological approach Pieter Roel Tuinman, M.D., PhD, intensivist Department of Intensive Care, VU Medical Center, Amsterdam, The Netherlands p.tuinman@vumc.nl Content Introduction
More informationArterial Blood Gases Interpretation Definition Values respiratory metabolic
Arterial Blood Gases Interpretation Definition A blood gas test measures the amount of oxygen and carbon dioxide in the blood. It is also useful in determining the ph level of the blood. The test is commonly
More informationPedsCases Podcast Scripts
PedsCases Podcast Scripts This is a text version of a podcast from Pedscases.com on Approach to Acid-Base Disturbance. These podcasts are designed to give medical students an overview of key topics in
More informationa. Describe the physiological consequences of intermittent positive pressure ventilation and positive end-expiratory pressure.
B. 10 Applied Respiratory Physiology a. Describe the physiological consequences of intermittent positive pressure ventilation and positive end-expiratory pressure. Intermittent positive pressure ventilation
More informationANATOMY & PHYSIOLOGY - CLUTCH CH ACID-BASE BALANCE-- CONTROLLING BLOOD PH
!! www.clutchprep.com ANATOMY & PHYSIOLOGY - CLUTCH CONCEPT: INTRO. TO DISTURBING AND MAINTAINING BLOOD ph Physiological Sources of Acid (and Base): Acids are molecules/substances that H+ to a solution.
More informationAcid/Base Disorders 2015
Objectives - 2 1. Identify acid/base disorders 2. Discuss etiologies for 1 0 acid/base disorders (will not include mixed disorders) 3. Interpret acid/base disorders by interpreting arterial blood gas &
More informationDr. Puntarica Suwanprathes. Version 2007
Dr. Puntarica Suwanprathes Version 2007 O 2 and CO 2 transport in blood Oxyhemoglobin dissociation curve O 2 consumption (VO 2 ) CO 2 production (VCO 2 ) O 2 capacity O 2 content: CaO 2 or CvO 2 %saturation
More informationAcid Base Balance by: Susan Mberenga RN, BSN, MSN
Acid Base Balance by: Susan Mberenga RN, BSN, MSN Acid Base Balance Refers to hydrogen ions as measured by ph Normal range: 7.35-7.45 Acidosis/acidemia: ph is less than 7.35 Alkalosis/alkalemia: ph is
More informationAre you ready to have fun?
Arterial Blood Gas INTERPRETATION By Nena Bonuel, MSN, RN, CCRN, CNS, ACNS-BC Nurse Specialist, Center for Professional Excellence Are you ready to have fun? 1. Yes! 2. I rather go shopping 3. I still
More informationBlood Gases For beginners
Blood Gases For beginners Lynsey ward th February 2008 4 th Aims To have a basic understanding of Blood Gas analysis. Objectives To state what acid and alkaline in the value of PH When analysing a blood
More informationAcid-Base Imbalance. Shu-Yi (Emily) Wang, PhD, RN, CNS Denver School of Nursing
Acid-Base Imbalance Shu-Yi (Emily) Wang, PhD, RN, CNS gpwsy@hotmail.com Denver School of Nursing ph Ranges Compatible With Life In blood, the ph represents the relationship between the respiratory and
More informationBlood Gases 2: Acid-Base and Electrolytes Made Simple. Objectives. Important Fact #1
Blood Gases 2: Acid-Base and Electrolytes Made Simple Gary L. Horowitz, MD Beth Israel Deaconess Medical Center Boston, MA Objectives Identify the 4 major acid-base disturbances, giving typical values
More informationPhysiology week 16 Renal 2 (volume/buffers)
Physiology week 16 Renal 2 (volume/buffers) Defense of Tonicity and Volume Defense of tonicity Tonicity = osmolality of a solution relative to plasma Osmolality measures [ ] all particles in solution,
More informationInterpretation of the Arterial Blood Gas
Interpretation of the Arterial Blood Gas Self-Learning Packet This self-learning packet is approved for 2 contact hours for the following professionals: 1. Registered Nurse 2. Licensed Practical Nurse
More informationPrinciples of Anatomy and Physiology
Principles of Anatomy and Physiology 14 th Edition CHAPTER 27 Fluid, Electrolyte, and Acid Base Fluid Compartments and Fluid In adults, body fluids make up between 55% and 65% of total body mass. Body
More informationNote: During any ONE run the ph remains constant. It may be at any one of the above levels but it never change during a single run.
1 BGYC34 (2007) PhysioEx Lab 10 AcidBase Balance Marking Scheme Part 1 Complete PhysioEx lab #10. Handin all of the pages associated with the lab. Note that there are 9 activities to be completed. You
More informationPARAMEDIC RESOURCE MANUAL
ONTARIO BASE HOSPITAL GROUP PARAMEDIC RESOURCE MANUAL ACID-BASE BALANCE SECTION SIX Version 1.1 2010 Update PARAMEDIC RESOURCE MANUAL OBJECTIVES: ACID-BASE BALANCE The objectives indicate what you should
More informationThe relationship between H+,PaCO₂ and HCO₃ are expressed in the equation of:
[Acid-Base Balance] [Dr. Bashir Khasawneh] [5 th February 2012] Acid-Base Basic Concepts: The relationship between H+,PaCO₂ and HCO₃ are expressed in the equation of: Which is modified from Henderson-Hasselbach
More informationOXYGENATION AND ACID- BASE EVALUATION. Chapter 1
OXYGENATION AND ACID- BASE EVALUATION Chapter 1 MECHANICAL VENTILATION Used when patients are unable to sustain the level of ventilation necessary to maintain the gas exchange functions Artificial support
More informationsounds are distant with inspiratory crackles. He sits on the edge of his chair, leaning forward, with both hands on his
I NTE R P R ETI N G A R T E R I A L B L O O D G A S E S : EASY AS A B C Take this step-by-step approach to demystify the parameters of oxygenation, ventilation, acid-base balance. BY WILLIAM C. PRUITT,
More informationChapter 27: WATER, ELECTROLYTES, AND ACID-BASE BALANCE
Chapter 27: WATER, ELECTROLYTES, AND ACID-BASE BALANCE I. RELATED TOPICS Integumentary system Cerebrospinal fluid Aqueous humor Digestive juices Feces Capillary dynamics Lymph circulation Edema Osmosis
More informationACID-BASE DISORDERS. Assist.Prof.Dr. Filiz BAKAR ATEŞ
ACID-BASE DISORDERS Assist.Prof.Dr. Filiz BAKAR ATEŞ Acid-Base Regulation Metabolic processes continually produce acid and, to a lesser degree, base. Hydrogen ion (H+) is especially reactive; it can attach
More informationDisorders of Acid-Base Balance
OpenStax-CNX module: m46413 1 Disorders of Acid-Base Balance OpenStax College This work is produced by OpenStax-CNX and licensed under the Creative Commons Attribution License 3.0 By the end of this section,
More informationPICU Resident Self-Study Tutorial Interpreting Blood Gases
Christopher Carroll, MD INTRODUCTION Blood gases give us a huge amount of information regarding the patient s physiologic condition and are the best method available to assess a patient s oxygenation and
More informationACID-BASE BALANCE URINE BLOOD AIR
ACIDBASE BALANCE URINE BLOOD AIR H 2 PO 4 NH 4 HCO 3 KIDNEY H H HCO 3 CELLS Hb H LUNG H 2 CO 3 HHb CO 2 H 2 O ph = 7.4 [HCO 3 ] = 24 meq/l PCO 2 = 40 mm Hg CO 2 PRIMARY RENAL MECHANISMS INVOLVED IN ACIDBASE
More informationInter Inter Pretation of Acid Base Disturbance in Critically ill Patients. By :-: Dr. Vinay Bhomia M.D.
Inter Inter Pretation of Acid Base Disturbance in Critically ill Patients. By :-: Dr. Vinay Bhomia M.D. Normal Blood PH 7.35 to 7.45 Crucial importance to maintain homeostatic function of Body. Any Significant
More informationInterpretation of Arterial Blood Gases (ABG)
Interpretation of Arterial Blood Gases (ABG) Prof. Dr. W. Vincken Head Respiratory Division Universitair Ziekenhuis Brussel (UZ Brussel) Vrije Universiteit Brussel (VUB) 29-3-2015 W Vincken - UZ Brussel
More informationWater, Electrolytes, and Acid-Base Balance
Chapter 27 Water, Electrolytes, and Acid-Base Balance 1 Body Fluids Intracellular fluid compartment All fluids inside cells of body About 40% of total body weight Extracellular fluid compartment All fluids
More informationLecture 19, 04 Nov 2003 Chapter 13, Respiration, Gas Exchange, Acid-Base Balance. Vertebrate Physiology ECOL 437 University of Arizona Fall 2003
1 Lecture 19, 04 Nov 003 Chapter 13, Respiration, Gas Exchange, Acid-Base Balance Vertebrate Physiology ECOL 437 University of Arizona Fall 003 instr: Kevin Bonine t.a.: Bret Pasch Vertebrate Physiology
More informationi. Zone 1 = dead space ii. Zone 2 = ventilation = perfusion (ideal situation) iii. Zone 3 = shunt
Respiratory Review I. Oxygen transport a. Oxygen content of blood i. Dissolved oxygen =.003 x PaO 2, per 100 ml plasma 1. Henry s Law ii. Oxygen on hemoglobin = 1.34 ml x sat x Hgb iii. CaO 2 = Dissolved
More informationCHAPTER 27 LECTURE OUTLINE
CHAPTER 27 LECTURE OUTLINE I. INTRODUCTION A. Body fluid refers to body water and its dissolved substances. B. Regulatory mechanisms insure homeostasis of body fluids since their malfunction may seriously
More information3/19/2009. The task of the kidney in acid-base balance Excretion of the daily acid load. Buffering of an acid load. A o B - + H + B - A o +OH - C +
The task of the kidney in acid-base balance Excretion of the daily acid load Buffering of an acid load Oxidation of amino acids, fats and carbohydrates often lead to acid production. On an average American
More informationHYDROGEN ION HOMEOSTASIS
ACID BASE BALANCE 1 HYDROGEN ION HOMEOSTASIS Free H + ions are present in very minute quantity in the blood (is around 1 in 3 million of Na + concentration) H + ion concentration is 0.00004 meq/l Na +
More informationSteady a disturbed equilibrium
Steady a disturbed equilibrium Accurately interpret the acidbase balance of acutely ill patients. By Susan J. Appel, APRN,BC, CCRN, PhD, and Charles A. Downs, APRN,BC, CCRN, MSN DDerangements in acidbase
More informationPHYSIOLOGY EXAMINATION Unit Exam #3 December 11, :30 PM-4:30 PM
PHYSIOLOGY EXMINTION Unit Exam #3 December 11, 2001 1:30 PM-4:30 PM Directions: Select the one best answer and fill in the space below the corresponding letter on the answer sheet. Commonly used respiration,
More informationOpenStax-CNX module: m Transport of Gases. OpenStax College. Abstract
OpenStax-CNX module: m46545 1 Transport of Gases OpenStax College This work is produced by OpenStax-CNX and licensed under the Creative Commons Attribution License 3.0 By the end of this section, you will
More information3. Which statement is false about anatomical dead space?
Respiratory MCQs 1. Which of these statements is correct? a. Regular bronchioles are the most distal part of the respiratory tract to contain glands. b. Larynx do contain significant amounts of smooth
More informationInterpretation of ABG. Chandra Shekhar Bala, FCPS( Medicine) Junior Consultant NINS and Hospital, Dhaka
Interpretation of ABG Chandra Shekhar Bala, FCPS( Medicine) Junior Consultant NINS and Hospital, Dhaka ABG analysis of Ms Rubi Ms. Rubi, 20 year-old lady PH 7.29 presented with breathlessness. She had
More informationCh 17 Physiology of the Kidneys
Ch 17 Physiology of the Kidneys Review Anatomy on your own SLOs List and describe the 4 major functions of the kidneys. List and explain the 4 processes of the urinary system. Diagram the filtration barriers
More informationIntroduction. Acids, Bases and ph; a review
0 P a g e Introduction In this sheet, we discuss acidbase balance in our body and the role of kidneys in its establishment. Arrangement of topics is different from that of the lecture, to assure consistency
More informationControl of Breathing
Physio # 11 Dr. Yanal Shafaqoj Done By: Lejan Al - Dof'at 13/12/13 Control of Breathing We talked previously about Oxygen extraction and CO 2 production, and how these are transfused through blood (in
More informationArterial Blood Gases. Dr Mark Young Mater Health Services
Arterial Blood Gases Dr Mark Young Mater Health Services Why do them? Quick results Bedside test Range of important information Oxygenation Effectiveness of gas exchange Control of ventilation Acid base
More information