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INTERPRETATION OF
ABGS
1. Iidentify Acidosis or alkalosis
2. PH 7.35 to 7.45
3. Ph <7.35 Acidosis
4. Ph >7.45 Alkalosis
5. Ph =7.40 absolute
6. Ph 7.35 to 7.40 Acidosis Range
7. Ph 7.40 to 7.45 Alkalosis range
METABOLIC OR RESPIRATORY
• Rome Method
• Ph decreased, pco2 Increased =respiratory disorder
• Ph decreased pco2 decreased = metabolic disorder
• 2. More co2 more H+ Acidosis ph will be less
• More hco3 alkalosis more ph
• Tic tac toe mathod
EXAMPLES
• 1. Ph 7.25
• paco2 50
• HCo3 24
• Acidosis Normal alkalosis
• ph hco3
• Co2
• Respiratory Acidosis
• Ph 7. 5 pco2 28 Hco3 22
• Acidosis Normal Alkalosis
• hco3. , ph Pco2
• RESPiratory alkalosis
METABOLIC OR RESPIRATORY
• Rome Method
• Ph
COMPENSATION
• Partially or fully compensated
• In case of respiratory Acidosis hco3 will inc to compensate
• In case of respiratory alkalosis Hco3 will dec
In case of metabolic Acidosis co2 will decrease
In case of metabolic alkalosis co2 will increase
EXAMPLE
• Ph 7.30 co2 50 hco3 49
• ph dec Acidosis
• Co2 inc.. Leading to increase in H+
• Hco3 inc to compensate
• respiratory Acidosis partially compensated
• PH 7. 5. Pco2 51 hco3 41
• ph Aalkalosis
• Pco2 compensation
• hco3 METABOLIC
• METABOLIC ALKALOSIS PARTIALLY COMPENSATED
FULLY COMPENSATED
• PH shoull be i with in normal range
• e. G
• ph7.44 Pco2 48 hco3 35
• Ph is normal but more in alkalosis range so alkalosis
• hco3 s increased. So it’s metabolic
• Co2 inc
• Metabolic alkalosis fully compensated
• Ph 7.35 co2 49 hco3 30
• respiratory Acidosis fully compensated
WINTERS FORMULA
• Pco2 )(1.5 * hco3) +8 +- 2
• Eg if hco3 is 10
• Pco2 21 to 25. So.
• Co2 21 to 25 = adequate compensation
• Co2 < normal range = associated respiratory alkalosis
• Co2 > normal range = associated respiratory Acidosis
• Or pco2 = hco3 +15
METABOLIC ACIDOSIS AND AG
• Ag is unmeasured anions
ANION GAP METABOLIC ACIDOSIS
• Anion gap = NA – (HCO3 +CL)
• NORMAL RANGE - 6 12
• NORMAL AG METABOLIC ACIDOSIS
• LOOS OF NAHCO3 OR GAIN HCL
• EG NS DIARRHEA Rta CAI
• Inc anion gap metabolic Acidosis
• HA ~H+ A-
• Dka Lactic Acidosis toxins
• Dec anion gap metabolic Acidosis
• Mm / HYPERPARATHYRIDISm
DELTA DELTA GAP
• Diff in AG / diff in Hco3 = Ag – 12/ 24-hco3
• HA~ H+. A-
• H+ + HCO3 = H2CO3
• SO,.
• DIFF IN AG / DIFF IN HCO3 =1 ~~ PROPTIONAL LOSS OF HCO3 FOR EVERY
H+ ( PURE ANION GAP METABOLIC ACIDOSIS)
• Diff in AG /diff in Hco3 >1 less loss of hco3 than h+ generated (Superimposed
metabolic alkalosis)
• Diff in AG!/ diff in Hco3 < 1 more hco3 lost than h generated (Superimposed
metabolic Acidosis)
CORRECTION FIR ALBUMIN
• Corrected alb = Ag = 2.5*(4-alb)
• Osmolar gap 2*(NA+k)+urea/2.8 + glucose /18

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Abgs 2

  • 2. 1. Iidentify Acidosis or alkalosis 2. PH 7.35 to 7.45 3. Ph <7.35 Acidosis 4. Ph >7.45 Alkalosis 5. Ph =7.40 absolute 6. Ph 7.35 to 7.40 Acidosis Range 7. Ph 7.40 to 7.45 Alkalosis range
  • 3. METABOLIC OR RESPIRATORY • Rome Method • Ph decreased, pco2 Increased =respiratory disorder • Ph decreased pco2 decreased = metabolic disorder • 2. More co2 more H+ Acidosis ph will be less • More hco3 alkalosis more ph • Tic tac toe mathod
  • 4. EXAMPLES • 1. Ph 7.25 • paco2 50 • HCo3 24 • Acidosis Normal alkalosis • ph hco3 • Co2 • Respiratory Acidosis
  • 5. • Ph 7. 5 pco2 28 Hco3 22 • Acidosis Normal Alkalosis • hco3. , ph Pco2 • RESPiratory alkalosis
  • 6. METABOLIC OR RESPIRATORY • Rome Method • Ph
  • 7. COMPENSATION • Partially or fully compensated • In case of respiratory Acidosis hco3 will inc to compensate • In case of respiratory alkalosis Hco3 will dec In case of metabolic Acidosis co2 will decrease In case of metabolic alkalosis co2 will increase
  • 8. EXAMPLE • Ph 7.30 co2 50 hco3 49 • ph dec Acidosis • Co2 inc.. Leading to increase in H+ • Hco3 inc to compensate • respiratory Acidosis partially compensated
  • 9. • PH 7. 5. Pco2 51 hco3 41 • ph Aalkalosis • Pco2 compensation • hco3 METABOLIC • METABOLIC ALKALOSIS PARTIALLY COMPENSATED
  • 10. FULLY COMPENSATED • PH shoull be i with in normal range • e. G • ph7.44 Pco2 48 hco3 35 • Ph is normal but more in alkalosis range so alkalosis • hco3 s increased. So it’s metabolic • Co2 inc • Metabolic alkalosis fully compensated
  • 11. • Ph 7.35 co2 49 hco3 30 • respiratory Acidosis fully compensated
  • 12. WINTERS FORMULA • Pco2 )(1.5 * hco3) +8 +- 2 • Eg if hco3 is 10 • Pco2 21 to 25. So. • Co2 21 to 25 = adequate compensation • Co2 < normal range = associated respiratory alkalosis • Co2 > normal range = associated respiratory Acidosis
  • 13. • Or pco2 = hco3 +15
  • 14. METABOLIC ACIDOSIS AND AG • Ag is unmeasured anions
  • 15. ANION GAP METABOLIC ACIDOSIS • Anion gap = NA – (HCO3 +CL) • NORMAL RANGE - 6 12 • NORMAL AG METABOLIC ACIDOSIS • LOOS OF NAHCO3 OR GAIN HCL • EG NS DIARRHEA Rta CAI
  • 16. • Inc anion gap metabolic Acidosis • HA ~H+ A- • Dka Lactic Acidosis toxins • Dec anion gap metabolic Acidosis • Mm / HYPERPARATHYRIDISm
  • 17. DELTA DELTA GAP • Diff in AG / diff in Hco3 = Ag – 12/ 24-hco3 • HA~ H+. A- • H+ + HCO3 = H2CO3 • SO,. • DIFF IN AG / DIFF IN HCO3 =1 ~~ PROPTIONAL LOSS OF HCO3 FOR EVERY H+ ( PURE ANION GAP METABOLIC ACIDOSIS)
  • 18. • Diff in AG /diff in Hco3 >1 less loss of hco3 than h+ generated (Superimposed metabolic alkalosis) • Diff in AG!/ diff in Hco3 < 1 more hco3 lost than h generated (Superimposed metabolic Acidosis)
  • 19. CORRECTION FIR ALBUMIN • Corrected alb = Ag = 2.5*(4-alb)
  • 20. • Osmolar gap 2*(NA+k)+urea/2.8 + glucose /18