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Blood gas analysis and acid-basic disorder

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* CO2 Blood Gas Analysis Arterial blood Sea level (101.3kPa, 760mmHg) Quiet Anti-coagulate blood Inspire air ... – PowerPoint PPT presentation

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Title: Blood gas analysis and acid-basic disorder


1
Blood gas analysis and acid-basic disorder
2
Blood Gas Analysis
  • Arterial blood
  • Sea level (101.3kPa, 760mmHg)
  • Quiet
  • Anti-coagulate blood
  • Inspire air (Whether O2 supply)

3
Clinical Significance
  • To evaluate respiratory failure
  • type ? or type ?
  • To evaluate acid-basic disorder

4
How to evaluate respiratory failure?
  • PaO2
  • Arterial blood oxygenic partial pressure.
  • Normal 95-100mmHg (12.6-13.3kPa)
  • Estimate formula of age
  • PaO2100mmHg-(age0.33) 5mmHg

5
Hypoxia
  • Mild 80-60mmHg
  • Mediate 60-40mmHg
  • Severe lt40mmHg

6
Respiratory Failure
  • PaO2lt60mmHg respiratory failure
  • Notice sea level, quiet, inspire air
  • rule off other causes ( heart
  • disease)

7
Classification of Respiratory Failure
  • PaCO2 The carbon dioxide partial pressure
  • of arterial blood
  • Normal 35-45mmHg (4.7-6.0kPa)
  • mean 40mmHg

8
Classification of Respiratory Failure
  • Type ?
    Type?
  • PaO2 (mmHg) lt60 lt60
  • PaCO2 (mmHg) 50 gt50

9
Other Parameters
  • SaO2 Saturation of arterial blood oxygen
  • Normal 0.95-0.98
  • Significance a parameter to evaluate hypoxia,
    but not sensitive
  • ODC ( Dissociation curve of oxygenated
    hemoglobin) S shape

10
SaO2
PO2
Oxygen dissociation curve
11
PH
2,3DPG
temperature
CO2
ODC to right deviation
Oxygenated hemoglobin release oxygen to tissue,
prevent hypoxia of the tissue. But absorbed
oxygen of hemoglobin is decreased from the
alveoli.
Bohr effect movement of ODC place is
induced by PH.
12
  • PA-aO2 Difference of alveoli-arterial blood
    oxygenic partial pressure.
  • Normal 15-20mmHg (lt30mmHg in the old)
  • Significance a sensitive parameter in gas
    exchange

13
  • PvO2 Oxygenic partial pressure of mixed venous
    blood.
  • Normal 35-45mmHg
  • mean 40mmHg
  • Significance Pa-vO2 is to reflect the tissue
    absorbing oxygen.

14
  • CaO2 The content of the oxygen of the arterial
    blood.
  • Normal 19-21mmol/L
  • Significance a comprehensive parameter to
    evaluate arterial oxygen.

15
Parameters in acid-basic disorder evaluation
  • PH negative logarithm of Hydrogen ion
    concentration.
  • Normal 7.35-7.45
  • mean 7.4

?HCO3- ?
PHPkalog
0.03PaCO2
20
6.1log
1
16
  • HCO3- (bicarbonate)
  • SB (standard bicarbonate)
  • AB (actual bicarbonate)
  • SB the contents of HCO3- of serum of arterial
  • blood in 38?, PaCO2 40mmHg, SaO2 100.
  • Normal 22-27mmol/L
  • mean 24mmol/L
  • AB The contents of HCO3- in actual condition.
  • In normal person ABSB

17
  • AB and SB are parameters to reflect
  • metabolism, regulated by kidney.
  • Difference of AB-SB can reflect the
  • respiratory affection on serum HCO3- .
  • Respiratory acidosis ABgtSB
  • Respiratory alkalosis ABltSB
  • Metabolic acidosis ABSBltNormal
  • Metabolic alkalosis ABSBgtNormal

18
  • Buffer bases(BB)
  • is the total of buffer negative ion of
    blood.
  • BB HCO3-
  • hemoglobin
  • plasma proteins
  • HPO42- (phosphate)
  • Normal 45-55mmol/L
  • mean 50mmol/L
  • Significance Metabolic acidosis BB
  • Metabolic alkalosis BB

19
  • Bases excess (BE)
  • the acid or bases used to regulate blood PH
    7.4 . ( in 38?,PaCO2 40mmHg, SaO2 100)
  • Normal 02.3 mmol/L
  • Significance
  • add acid BE(), BB
  • add base BE(-), BB

20
  • Total plasma CO2 (T-CO2)
  • total content of the CO2 .
  • Normal HCO3- gt95

21
  • Anion gap (AG)
  • the difference of undetermined anion and
    undetermined cation in serum.
  • AGNa-(Cl- HCO3- )
  • Normal 8-16mmol/L
  • Significance
  • AG acidosis ketoacidosis, kidney
    failure
  • AG normal acidosis Cl , diarrhea,
    fixed
  • acid decrease
  • to evaluate mix acid-basic disorder

22
Regulation of Acid-basic Balance
  • Chemical buffer
  • Dielectric changes of incells and excells
  • H---K, HCO3- ---Cl-
  • Physiology regulation of the lung and kidney

23
Classification of Acid-basic Disorder
  • Complementary PH is normal
  • Dis-complementary PH is abnormal.
  • PH, PaCO2, HCO3- are three important parameters
    in acid-basic disorder evaluation.

24
Classification of Acid-basic Disorder
  • PH PaCO2 HCO3-
  • Resp. acidosis
  • Resp. alkalosis
  • Meta. acidosis
  • Meta. alkalosis

25
Classification of Acid-basic Disorder
  • Mixed acid-basic disorder
  • Complementary formula
  • example
  • original disorder chronic respiratory
    acidosis
  • ? HCO3- ?PaCO2 0.355.58
  • complementary limit 45mmol/L

26
Classification of Acid-basic Disorder
  • Respiratory acidosis with metabolic acidosis
  • Respiratory acidosis with metabolic alkalosis
  • Respiratory alkalosis with metabolic acidosis
  • Respiratory alkalosis with metabolic alkalosis

27
Respiratory acidosis with metabolic acidosis
  • PaCO2
  • HCO3- , normal, (slight)
  • AB, SB, BB , normal, (slight)
  • PH
  • BE negative value

28
Respiratory acidosis with metabolic alkalosis
  • PaCO2
  • AB
  • PH , N,

29
Mixed by three types of disorder
  • Respiratory acidosis metabolic acidosis
  • metabolic alkalosis
  • Respiratory alkalosis metabolic acidosis
  • metabolic alkalosis
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