Cara Membaca Analisis Gas Darah Arteri (AGDA).ppt

BLOOD GAS ANALYSISHasanul Arifin Departemen Anestesiologi dan ReanimasiFKUSU RSUP. H. Adam Malik Medan

Apa yang dibaca ? pH, PaCO2, BE HCO3, PaO2, SaO2Hasanul-2004

STEPS IN ACIDS BASE CLASSIFICATION pH Classification PaCO2 Classification Metabolic Classification Compensation Evaluation Complete Acid-Base ClassificationHasanul-2004

pH ClassificationClassificationNormalAcidosisAlkalosispH7.35-7.45< 7.35>7.45Hasanul-2004

Classification of Laboratory Respiratory Acid-Base ComponentClassificationNormal Resp.ComponentRespiratory AcidosisRespiratory Alkalosis

PaCO2 (mmHg)35-45>45

Classification of Laboratory Metabolic Acid-Base ComponentClassificationNormal Metab.ComponentMetabolic AcidosisMetabolic Alkalosis

BE02< -2> +2HCO324226Hasanul-2004

Langkah LangkahBaca pH normal, acidosis, alkalosisLihat PaCO2 atau BE, mana yg searah dengan pHBila PaCO2 yang searah respiratorik sebagai proses primerBila BE yang searah metabolik sebagai proses primerBila proses primer sudah diketahui, lihat dimana posisi komponen yg lain :Bila berlawanan proses kompensasiBila searah proses gandaBila posisi normal belum atau tidak ada proses kompensasihasanul-2004

7,3545-2227,4535+226pHPaCO2BEHCO3ACIDOSISALKALOSISEddy Rahardjo1990/Hasanul-2004

pH : 7.28, PaCO2 : 40, BE : -107,3545-2227,4535+226pHPaCO2BEHCO3ACIDOSISALKALOSIS7.28-1040Acidosis metabolik tanpa kompensasihasanul-2004

pH : 7.32, PaCO2 : 55, BE : +17,3545-2227,4535+226pHPaCO2BEHCO3ACIDOSISALKALOSIS7.32Acidosis respiratorik tanpa kompensasi55+1hasanul-2004

7,3545-2227,4535 +226pHPaCO2BEHCO3ACIDOSISALKALOSISpH : 7,50 ; PaCO2 : 30 ; BE : -2 ;7,5030Alkalosis respiratorik tanpa kompensasihasanul-2004

7,3545-2227,4535 +226pHPaCO2BEHCO3ACIDOSISALKALOSISpH : 7,55 ; PaCO2 : 30 ; BE : +5 ;7,5530Alkalosis respiratorik dan metabolik (proses ganda)+5Hasanul-2004

Steps in Evaluation and Classification of Acid-Base Compensation Evaluate for the presence of compensation Determine the probable primary problem Classify the degree of compensationHasanul-2004

Determination of the primary problempH 7.40-7.45

pH 7.35-7.40

Alkalosis is primaryAcidosis is compensatory

Acidosis is primary,Alkalosis is compensatoryHasanul-2004

Classification of degree of CompensationpH7.35-7.457.45Degree of compensationCompletePartialPartialHasanul-2004

7,3545-2227,4535 +226pHPaCO2BEHCO3ACIDOSISALKALOSISpH : 7,48 ; PaCO2 : 30 ; BE : -6 ;7,4830Alkalosis respiratorik dgn kompensasi parsial-6hasanul-2004

pH : 7.32, PaCO2 : 30, BE : -107,3545-2227,4535+226pHPaCO2BEHCO3ACIDOSISALKALOSIS7.32-1030Acidosis metabolik dgn kompensasi parsialhasanul-2004

pH : 7.38, PaCO2 : 30, BE : -107,3545-2227,4535+226pHPaCO2BEHCO3ACIDOSISALKALOSIS-1030Acidosis metabolik dgn kompensasi penuh7,38Hasanul-2003

7,3545-2227,4535 +226pHPaCO2BEHCO3ACIDOSISALKALOSISpH : 7,43 ; PaCO2 : 30 ; BE : -6 ;7,4330Alkalosis respiratorik dgn kompensasi penuh-6Hasanul-2003

Severity of Generalized Acid-Base disturbancespH7,55Degree of ImpairmentSevere AcidosisModerate AcidosisMild AcidosisNormal pHMild AlkalosisModerate AlkalosisSevere AlkalosisHasanul-2003

Normal Arterial GasesParameterpHPaCO2PaO2SaO2Values7,35-7,4535-45 mmHg80-100 mmHg98-100%Hasanul-2003

Normal mixed venous gasesParameterpHPaCO2PaO2SaO2Values7,3848 mmHg40 mmHg75%Hasanul-2003

7,58 20 19 63 7,44 52 34 28 7,21 66 26 47 7.44 31 20 111 7,60 28 27 59 7,50 50 37 75 7,41 42 25 229 7,52 41 32 49 7,44 28 35 87 7,44 35 23 97No. pH PaCO2 HCO3 PaO2 ClassificationHasanul-2003

7.32 30 -10 58 7.52 34 +4 32 7.36 32 - 4 145 7.42 30 - 5 90 7.20 50 - 9 60 7.20 80 +2 90 7.55 25 0 72 7.34 30 - 9 41 7.37 56 +4 57 7.40 38 - 2 350 No. pH PaCO2 BE PaO2 ClassificationHasanul-2003

Kam shia

Terima Kasih