This document provides an overview of blood gas interpretation and acid-base physiology: 1) It discusses factors that can affect blood gas results like improper sampling technique and gives normal ranges for pH, PCO2, and HCO3. 2) Key concepts in acid-base physiology like the Henderson-Hasselbalch equation, bicarbonate buffering system, and renal regulation of bicarbonate are summarized. 3) The document outlines the pathophysiology and clinical effects of various acid-base disturbances like respiratory acidosis and metabolic alkalosis.

1. Blood Gas Interpretation 2005/8/25

10. PaCO 2 PaCO 2 > 40 mmHg, MV = 2x normal PaCO 2 > 80 mmHg  CO2 nacrosis

12. Proximal Renal Tubule

13. Distal Renal Tubule

14. Distal Tubule – NH 4 + excretion

21. Renal failure (acute and chronic) Starvation Salicylates Alcoholic Methanol Diabetic Ethylene glycol Ketoacidosis Toxins Lactic acidosis Causes of High-Anion-Gap Metabolic Acidosis

29. N Respiratory alkalosis Metabolic alkalsosis Metabolic acidosis Respiratory acidosis 7.4 7.6 7.2 pH 30 40 50 PCO 2 (mmHg) Determination of primary acid-base disorders

32. [HCO3-] will ↑ 4 mmol/L per 10-mmHg ↑ in PaCO2 Chronic [HCO3-] will ↑ 1 mmol/L per 10-mmHg ↑ in PaCO2 Acute Respiratory acidosis [HCO3-] will ↓ 4 mmol/L per 10-mmHg ↓ in PaCO2 Chronic [HCO3-] will ↓ 2 mmol/L per 10-mmHg ↓ in PaCO2 Acute Respiratory alkalosis PaCO2 = [HCO3-] + 15 PaCO2 will ↑ 6 mmHg per 10-mmol/L ↑ in [HCO3-] or PaCO2 will ↑ 0.75 mmHg per mmol/L ↑ in [HCO3-] or Metabolic alkalosis PaCO2 = [HCO3-] + 15 PaCO2 will ↓ 1.25 mmHg per mmol/L ↓ in [HCO3-] or PaCO2 = (1.5x HCO3-) + 8 or Metabolic acidosis Prediction of Compensation Disorder Prediction of Compensatory Responses on Simple Acid-Base Disturbances

35. Mixed Acid Base Disorders Metabolic alkalosis Metabolic acidosis Respiratory alkalosis Respiratory acidosis    Metabolic alkalosis    Metabolic acidosis   Respiratory alkalosis   Respiratory acidosis Secondary Primary

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