Acid Base Terminology - Mount Sinai Health System...Pulmonary Module Slide 3-2 ©AACN 2001 Normal...

Pulmonary Module ©AACN 2001Slide 3-1

Acid Base Terminology

Pulmonary Module ©AACN 2001Slide 3-2

Normal Arterial Blood Gas Values*

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Acidemia vs Alkalemia

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Buffers

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Respiratory System

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Renal System

To compensate or correct

To compensate or correct

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Tubular Control of H+ by the Bicarbonate-Carbonic AcidSystem

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Tubular Control of H+ by Phosphate

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Tubular Control of H+ by Ammonia

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Correction vs Compensation

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Steps to Acid Base Interpretation

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Practice Acid Base Interpretation

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Compensation

7.37

7.42

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Practice Acid Base Interpretation (Compensation)

7.46

7.34

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Combined Disorders

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Respiratory Acidosis

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Respiratory Alkalosis

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Metabolic Acidosis

pH < 7.35

PaCO2 normal (rarely) or decreased

HCO3- < 22 meq/l.

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Anion Gap

--

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Metabolic Alkalosis

normal (rarely) or increased

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Arterial and Mixed Venous Gases

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Oxyhemoglobin Dissociation Curve

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Oxyhemoglobin Dissociation Curve: Causes of Shifts

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Factors Leading to Tissue Hypoxia

Low cardiac output

Decreased oxygen carrying capacity

Non-functional hemoglobin

Right to left cardiac shunt

Impaired respiration

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Body’s Compensation for Tissue Hypoxia

Tachycardia

Tachypnea

Erythrocytosis

Further desaturation of hemoglobin