this slide focuses on all the acid base disorder pertaining to the respiratory system. it focus on the compensatory mechanism, causes, clinical features and treatment.
Pulmonary edema is the accumulation of fluid in the lungs, which makes breathing difficult. It occurs when fluid leaks into the tiny air sacs in the lungs called alveoli. This fluid buildup is usually due to heart failure or conditions that increase blood pressure in the lungs. Common symptoms include shortness of breath, cough, and wheezing. Diagnosis involves listening to the chest, chest x-rays, and echocardiograms. Treatment focuses on reducing fluid buildup through diuretics, oxygen therapy, and treating the underlying cause.
This document defines and classifies hyperkalemia based on potassium levels. It discusses the clinical presentation, epidemiology, etiology, and pathophysiology of hyperkalemia. The diagnostic methods and management approaches are also outlined. Hyperkalemia is managed through non-pharmacological treatments like dialysis for severe cases. Pharmacological treatments work to antagonize potassium effects, redistribute potassium into cells, or remove excess potassium from the body using calcium, insulin, beta-agonists, cation exchange resins, and diuretics.
The document discusses acute respiratory distress syndrome (ARDS), a life-threatening lung condition that prevents sufficient oxygen from entering the blood. ARDS can result from direct or indirect lung injury and causes fluid buildup in the lungs, reduced lung compliance, and impaired gas exchange. Symptoms include difficulty breathing, low blood oxygen levels, and abnormal breath sounds. Treatment focuses on supportive care in the ICU, including mechanical ventilation, supplemental oxygen, medications, and positioning strategies to improve ventilation.
This document discusses electrolyte imbalances including hypernatremia, hyponatremia, hypokalemia, and hyperkalemia. It defines each condition and describes their causes, clinical manifestations, treatment considerations, and anesthetic implications. Hypernatremia results from excessive sodium and is treated by slow correction of plasma sodium levels over 48 hours. Hyponatremia is caused by low sodium levels and rapid correction can cause serious neurological issues. Hypokalemia and hyperkalemia affect cardiac function and should be corrected before elective surgery, as potassium levels impact anesthetic drugs and muscle function.
by the renowned pediatrician, Dr Satish Deopujari,
National Chairperson (Ex)
Intensive Care Chapter I A P
Founder Chairman.....
National conference on pediatric critical care
Professor of pediatrics ( Hon ) JNMC:Wardha
Nagpur : INDIA
this slide focuses on all the acid base disorder pertaining to the respiratory system. it focus on the compensatory mechanism, causes, clinical features and treatment.
Pulmonary edema is the accumulation of fluid in the lungs, which makes breathing difficult. It occurs when fluid leaks into the tiny air sacs in the lungs called alveoli. This fluid buildup is usually due to heart failure or conditions that increase blood pressure in the lungs. Common symptoms include shortness of breath, cough, and wheezing. Diagnosis involves listening to the chest, chest x-rays, and echocardiograms. Treatment focuses on reducing fluid buildup through diuretics, oxygen therapy, and treating the underlying cause.
This document defines and classifies hyperkalemia based on potassium levels. It discusses the clinical presentation, epidemiology, etiology, and pathophysiology of hyperkalemia. The diagnostic methods and management approaches are also outlined. Hyperkalemia is managed through non-pharmacological treatments like dialysis for severe cases. Pharmacological treatments work to antagonize potassium effects, redistribute potassium into cells, or remove excess potassium from the body using calcium, insulin, beta-agonists, cation exchange resins, and diuretics.
The document discusses acute respiratory distress syndrome (ARDS), a life-threatening lung condition that prevents sufficient oxygen from entering the blood. ARDS can result from direct or indirect lung injury and causes fluid buildup in the lungs, reduced lung compliance, and impaired gas exchange. Symptoms include difficulty breathing, low blood oxygen levels, and abnormal breath sounds. Treatment focuses on supportive care in the ICU, including mechanical ventilation, supplemental oxygen, medications, and positioning strategies to improve ventilation.
This document discusses electrolyte imbalances including hypernatremia, hyponatremia, hypokalemia, and hyperkalemia. It defines each condition and describes their causes, clinical manifestations, treatment considerations, and anesthetic implications. Hypernatremia results from excessive sodium and is treated by slow correction of plasma sodium levels over 48 hours. Hyponatremia is caused by low sodium levels and rapid correction can cause serious neurological issues. Hypokalemia and hyperkalemia affect cardiac function and should be corrected before elective surgery, as potassium levels impact anesthetic drugs and muscle function.
by the renowned pediatrician, Dr Satish Deopujari,
National Chairperson (Ex)
Intensive Care Chapter I A P
Founder Chairman.....
National conference on pediatric critical care
Professor of pediatrics ( Hon ) JNMC:Wardha
Nagpur : INDIA
This document discusses the four types of respiratory failure:
1) Type 1 (hypoxemic) is characterized by low oxygen levels in the blood but normal or low carbon dioxide levels, usually due to issues with ventilation/perfusion matching.
2) Type 2 (hypercapnic/ventilatory) involves low oxygen and high carbon dioxide levels due to inadequate alveolar ventilation.
3) Type 3 (peri-operative) commonly occurs after surgery due to effects of anesthesia and abdominal issues.
4) Type 4 (shock) involves intubation during resuscitation for conditions like cardiogenic, hypovolemic, or septic shock. The document then provides details on the causes, characteristics
Pulmonary edema is fluid accumulation in the lungs caused by fluid leaking from blood vessels into the lungs. It can be cardiogenic (caused by heart problems increasing blood pressure in the lungs) or non-cardiogenic. Symptoms include shortness of breath, cough, and cyanosis. Diagnosis involves chest x-ray, echocardiogram, and measuring wedge pressure. Treatment focuses on reducing preload on the heart, lowering afterload, and providing supportive care like oxygen. Outcomes depend on the underlying cause but most cardiogenic cases resolve within 3 days with medical management.
This document discusses metabolic acidosis and alkalosis. It defines acids and bases, and explains how the body maintains acid-base balance through the lungs, kidneys, and buffer systems. Metabolic acidosis occurs when the body produces too much acid or the kidneys can't remove enough, decreasing the bicarbonate level. Causes include lactic acid, ketones, and renal failure. Metabolic alkalosis happens when bicarbonate increases, decreasing hydrogen ions, due to vomiting, diuretics, or base ingestion. Blood gas analysis measures pH, pCO2, and bicarbonate to diagnose acid-base disorders.
Metabolic alkalosis is a condition where the pH of the blood is elevated beyond the normal range due to a higher than normal bicarbonate level. This can be caused by loss of hydrochloric acid through vomiting or diarrhea, or by excessive intake of bicarbonate. The kidneys compensate by retaining bicarbonate, leading to hypokalemia and hypocalcemia. Symptoms include confusion, seizures, and muscle cramps or weakness. The condition is diagnosed based on arterial blood gas values showing elevated pH and bicarbonate levels. Treatment focuses on replacing fluid and electrolyte losses and identifying the underlying cause.
Acute respiratory failure occurs when the respiratory system fails to maintain adequate gas exchange. There are two main types: hypoxemic respiratory failure, characterized by low oxygen levels, and acute ventilatory failure, characterized by high carbon dioxide levels. Hypoxemic failure is most common and can result from conditions that impair gas exchange like pneumonia or pulmonary edema. Ventilatory failure involves impaired breathing and can be caused by conditions that increase breathing workload like COPD. Diagnosis involves blood gas analysis and imaging. Treatment focuses on supporting oxygenation and ventilation through oxygen supplementation, ventilation support, and treating underlying causes.
This document provides information on metabolic acidosis, including:
- Metabolic acidosis occurs when there is an excess of fixed or exogenous acids in the blood, accompanied by a drop in plasma bicarbonate concentration.
- It is classified based on calculations of anion gap, delta ratio, and osmolar gap. An increased anion gap suggests retained fixed acids while a normal anion gap acidosis involves bicarbonate loss.
- Causes include lactic acidosis, ketoacidosis, and renal tubular acidosis. Treatment involves identifying and treating the underlying cause while monitoring the patient and correcting fluid, electrolyte and pH imbalances.
Chronic kidney disease (CKD) is defined as abnormalities of kidney structure or function present for more than 3 months. CKD is staged based on glomerular filtration rate (GFR) from stage 1 (normal or high GFR) to stage 5 (kidney failure). Common causes of CKD in India include diabetes, hypertension, and glomerulonephritis. Symptoms vary depending on stage but may include fatigue, pruritus, nausea, and electrolyte imbalances. Treatment includes controlling risk factors, nutritional management, dialysis if needed, and potentially kidney transplantation for end stage renal disease.
Pulmonary edema is often caused by congestive heart failure. When the heart is not able to pump efficiently, blood can back up into the veins that take blood through the lungs. As the pressure in these blood vessels increases, fluid is pushed into the air spaces (alveoli) in the lungs.
1. Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. It can progress to severe sepsis and septic shock with increased organ dysfunction and risk of death.
2. Common signs and symptoms include fever, increased heart and respiratory rate, and altered mental status. Laboratory findings may include leukocytosis, thrombocytopenia, and elevated lactate. Blood cultures are positive in 20-40% of cases.
3. Treatment involves promptly administering broad-spectrum intravenous antibiotics after obtaining cultures, as well as identifying and treating the infection source. Outcomes depend on early recognition and treatment.
Rheumatic fever is an inflammatory disease that occurs after a streptococcal throat infection. It affects the heart, joints, skin, and brain. While rates have declined due to improved living standards, rheumatic heart disease remains an issue in India, with reported incidence varying from 0.12-11 cases per 1000 people. Rheumatic fever is diagnosed using modified Jones criteria of either two major symptoms or one major and two minor symptoms. Treatment focuses on bed rest, antibiotics to treat strep infections, aspirin, and managing symptoms like chorea. The goals are to eliminate strep bacteria, prevent permanent heart damage, palliate symptoms, and prevent recurrence.
Respiratory acidosis is a condition caused by a buildup of carbon dioxide in the body due to impaired lung function. This disrupts the body's acid-base balance, causing fluids like blood to become too acidic. Causes include lung diseases like asthma, obesity, and drugs that suppress breathing. Symptoms include confusion, fatigue, and shortness of breath. Treatment focuses on the underlying lung condition through medications, ventilation support, and oxygen if needed. The prognosis depends on the severity and cause of the respiratory acidosis.
Portal hypertension occurs when blood pressure increases in the portal venous system, which normally carries blood from the gastrointestinal tract to the liver. It is defined as a hepatic venous pressure gradient over 10mm Hg. There are three types - pre-hepatic, intra-hepatic, and post-hepatic - depending on the site of vascular obstruction. Common causes include cirrhosis, schistosomiasis, and portal vein thrombosis. Clinical manifestations involve complications from increased portosystemic shunting and include ascites, esophageal varices, hemorrhoids, and hepatic encephalopathy. Diagnostic evaluations involve blood tests, imaging, and endoscopy. Treatment options include medications, endoscopic therapy, TIPS procedure,
THIS PRESENTATION WILL COVER THE FOLLOWING AREAS
Definitions
Buffer systems
Regulatory systems
Anion Gap and Osmolar gap
Metabolic acidosis
Metabolic alkalosis
Respiratory acidosis
Respiratory alkalosis
Chronic renal failure (CRF) or end-stage renal disease (ESRD) is an irreversible deterioration of renal function that results in uremia. It is caused by decreased renal blood flow or systemic diseases like diabetes and hypertension. As renal function declines, patients experience electrolyte imbalances, anemia, fluid overload, and the buildup of waste products. Treatment focuses on managing complications through dialysis, medications, and dietary restrictions to control electrolytes, blood pressure, anemia, and bone disease. The ultimate treatment is renal transplantation to restore kidney function.
Hypokalemia, or low potassium levels, can have significant effects on muscles, the cardiovascular and nervous systems. It is defined as a potassium level below 3.5 mEq/L. The majority of potassium is found inside cells and is essential for various cellular functions through membrane pumps and channels. Causes of hypokalemia include reduced intake, redistribution into cells, and increased losses through the kidneys or gastrointestinal tract. Treatment focuses on replacing potassium stores through oral or intravenous supplementation, addressing the underlying cause, and preventing further losses and complications like cardiac arrhythmias.
1. Arterial blood gas analysis involves drawing an arterial blood sample to measure pH, PCO2, PO2, and HCO3 levels. It is used to diagnose acid-base imbalances and respiratory disorders.
2. Key steps in analyzing an ABG result include determining if the pH is acidic or alkaline, identifying the primary disorder, assessing the degree of compensation, and calculating anion and delta gaps if metabolic acidosis is present.
3. Common causes of acid-base imbalances include respiratory acidosis/alkalosis from lung disease and metabolic acidosis/alkalosis involving the kidneys. Mixed disorders with both respiratory and metabolic components can also occur.
This document provides information about acute respiratory distress syndrome (ARDS), including its pathophysiology, clinical manifestations, diagnosis, treatment, nursing care, and complications. ARDS is a respiratory failure condition caused by lung injury and results in increased permeability of the alveolar-capillary membrane. It progresses through exudative, proliferative, and fibrotic phases. Treatment involves supportive care, mechanical ventilation, positioning strategies, and managing complications such as nosocomial pneumonia and renal failure.
This document discusses potassium homeostasis and hyperkalemia. It notes that potassium is mainly intracellular and its serum level is tightly regulated between 3.5-5 mEq/L. Mechanisms involve sodium-potassium pumps and renal excretion. Causes of hyperkalemia include reduced renal excretion, intracellular shifts, and inadequate aldosterone levels. Symptoms range from none to muscle weakness to arrhythmias. Treatment focuses on antagonizing cardiac effects, driving potassium intracellularly, and removing excess potassium.
Acute kidney injury (AKI) is a potentially life-threatening
syndrome that occurs primarily in hospitalized patients
and frequently complicates the course of critically ill
patient.
Acute Kidney Injury is is (abrupt) reduction in kidney functions as evidence by changed in laboratory values; serum creatinine, blood urea nitrogen(BUN)and urine output
Respiratory acidosis and alkalosis are acid-base disorders caused by problems with ventilation.
Respiratory acidosis occurs when Paco2 is elevated due to conditions that decrease ventilation like lung disease or muscle fatigue. It causes a decrease in pH but HCO3 rises in compensation. Chronic respiratory acidosis is treated by gradually lowering Paco2.
Respiratory alkalosis is caused by excessive ventilation lowering Paco2, seen in anxiety, pain, or drug effects. It increases pH but HCO3 falls as the kidneys compensate. Severe acute respiratory alkalosis can reduce blood flow and cause arrhythmias.
This document discusses the four types of respiratory failure:
1) Type 1 (hypoxemic) is characterized by low oxygen levels in the blood but normal or low carbon dioxide levels, usually due to issues with ventilation/perfusion matching.
2) Type 2 (hypercapnic/ventilatory) involves low oxygen and high carbon dioxide levels due to inadequate alveolar ventilation.
3) Type 3 (peri-operative) commonly occurs after surgery due to effects of anesthesia and abdominal issues.
4) Type 4 (shock) involves intubation during resuscitation for conditions like cardiogenic, hypovolemic, or septic shock. The document then provides details on the causes, characteristics
Pulmonary edema is fluid accumulation in the lungs caused by fluid leaking from blood vessels into the lungs. It can be cardiogenic (caused by heart problems increasing blood pressure in the lungs) or non-cardiogenic. Symptoms include shortness of breath, cough, and cyanosis. Diagnosis involves chest x-ray, echocardiogram, and measuring wedge pressure. Treatment focuses on reducing preload on the heart, lowering afterload, and providing supportive care like oxygen. Outcomes depend on the underlying cause but most cardiogenic cases resolve within 3 days with medical management.
This document discusses metabolic acidosis and alkalosis. It defines acids and bases, and explains how the body maintains acid-base balance through the lungs, kidneys, and buffer systems. Metabolic acidosis occurs when the body produces too much acid or the kidneys can't remove enough, decreasing the bicarbonate level. Causes include lactic acid, ketones, and renal failure. Metabolic alkalosis happens when bicarbonate increases, decreasing hydrogen ions, due to vomiting, diuretics, or base ingestion. Blood gas analysis measures pH, pCO2, and bicarbonate to diagnose acid-base disorders.
Metabolic alkalosis is a condition where the pH of the blood is elevated beyond the normal range due to a higher than normal bicarbonate level. This can be caused by loss of hydrochloric acid through vomiting or diarrhea, or by excessive intake of bicarbonate. The kidneys compensate by retaining bicarbonate, leading to hypokalemia and hypocalcemia. Symptoms include confusion, seizures, and muscle cramps or weakness. The condition is diagnosed based on arterial blood gas values showing elevated pH and bicarbonate levels. Treatment focuses on replacing fluid and electrolyte losses and identifying the underlying cause.
Acute respiratory failure occurs when the respiratory system fails to maintain adequate gas exchange. There are two main types: hypoxemic respiratory failure, characterized by low oxygen levels, and acute ventilatory failure, characterized by high carbon dioxide levels. Hypoxemic failure is most common and can result from conditions that impair gas exchange like pneumonia or pulmonary edema. Ventilatory failure involves impaired breathing and can be caused by conditions that increase breathing workload like COPD. Diagnosis involves blood gas analysis and imaging. Treatment focuses on supporting oxygenation and ventilation through oxygen supplementation, ventilation support, and treating underlying causes.
This document provides information on metabolic acidosis, including:
- Metabolic acidosis occurs when there is an excess of fixed or exogenous acids in the blood, accompanied by a drop in plasma bicarbonate concentration.
- It is classified based on calculations of anion gap, delta ratio, and osmolar gap. An increased anion gap suggests retained fixed acids while a normal anion gap acidosis involves bicarbonate loss.
- Causes include lactic acidosis, ketoacidosis, and renal tubular acidosis. Treatment involves identifying and treating the underlying cause while monitoring the patient and correcting fluid, electrolyte and pH imbalances.
Chronic kidney disease (CKD) is defined as abnormalities of kidney structure or function present for more than 3 months. CKD is staged based on glomerular filtration rate (GFR) from stage 1 (normal or high GFR) to stage 5 (kidney failure). Common causes of CKD in India include diabetes, hypertension, and glomerulonephritis. Symptoms vary depending on stage but may include fatigue, pruritus, nausea, and electrolyte imbalances. Treatment includes controlling risk factors, nutritional management, dialysis if needed, and potentially kidney transplantation for end stage renal disease.
Pulmonary edema is often caused by congestive heart failure. When the heart is not able to pump efficiently, blood can back up into the veins that take blood through the lungs. As the pressure in these blood vessels increases, fluid is pushed into the air spaces (alveoli) in the lungs.
1. Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. It can progress to severe sepsis and septic shock with increased organ dysfunction and risk of death.
2. Common signs and symptoms include fever, increased heart and respiratory rate, and altered mental status. Laboratory findings may include leukocytosis, thrombocytopenia, and elevated lactate. Blood cultures are positive in 20-40% of cases.
3. Treatment involves promptly administering broad-spectrum intravenous antibiotics after obtaining cultures, as well as identifying and treating the infection source. Outcomes depend on early recognition and treatment.
Rheumatic fever is an inflammatory disease that occurs after a streptococcal throat infection. It affects the heart, joints, skin, and brain. While rates have declined due to improved living standards, rheumatic heart disease remains an issue in India, with reported incidence varying from 0.12-11 cases per 1000 people. Rheumatic fever is diagnosed using modified Jones criteria of either two major symptoms or one major and two minor symptoms. Treatment focuses on bed rest, antibiotics to treat strep infections, aspirin, and managing symptoms like chorea. The goals are to eliminate strep bacteria, prevent permanent heart damage, palliate symptoms, and prevent recurrence.
Respiratory acidosis is a condition caused by a buildup of carbon dioxide in the body due to impaired lung function. This disrupts the body's acid-base balance, causing fluids like blood to become too acidic. Causes include lung diseases like asthma, obesity, and drugs that suppress breathing. Symptoms include confusion, fatigue, and shortness of breath. Treatment focuses on the underlying lung condition through medications, ventilation support, and oxygen if needed. The prognosis depends on the severity and cause of the respiratory acidosis.
Portal hypertension occurs when blood pressure increases in the portal venous system, which normally carries blood from the gastrointestinal tract to the liver. It is defined as a hepatic venous pressure gradient over 10mm Hg. There are three types - pre-hepatic, intra-hepatic, and post-hepatic - depending on the site of vascular obstruction. Common causes include cirrhosis, schistosomiasis, and portal vein thrombosis. Clinical manifestations involve complications from increased portosystemic shunting and include ascites, esophageal varices, hemorrhoids, and hepatic encephalopathy. Diagnostic evaluations involve blood tests, imaging, and endoscopy. Treatment options include medications, endoscopic therapy, TIPS procedure,
THIS PRESENTATION WILL COVER THE FOLLOWING AREAS
Definitions
Buffer systems
Regulatory systems
Anion Gap and Osmolar gap
Metabolic acidosis
Metabolic alkalosis
Respiratory acidosis
Respiratory alkalosis
Chronic renal failure (CRF) or end-stage renal disease (ESRD) is an irreversible deterioration of renal function that results in uremia. It is caused by decreased renal blood flow or systemic diseases like diabetes and hypertension. As renal function declines, patients experience electrolyte imbalances, anemia, fluid overload, and the buildup of waste products. Treatment focuses on managing complications through dialysis, medications, and dietary restrictions to control electrolytes, blood pressure, anemia, and bone disease. The ultimate treatment is renal transplantation to restore kidney function.
Hypokalemia, or low potassium levels, can have significant effects on muscles, the cardiovascular and nervous systems. It is defined as a potassium level below 3.5 mEq/L. The majority of potassium is found inside cells and is essential for various cellular functions through membrane pumps and channels. Causes of hypokalemia include reduced intake, redistribution into cells, and increased losses through the kidneys or gastrointestinal tract. Treatment focuses on replacing potassium stores through oral or intravenous supplementation, addressing the underlying cause, and preventing further losses and complications like cardiac arrhythmias.
1. Arterial blood gas analysis involves drawing an arterial blood sample to measure pH, PCO2, PO2, and HCO3 levels. It is used to diagnose acid-base imbalances and respiratory disorders.
2. Key steps in analyzing an ABG result include determining if the pH is acidic or alkaline, identifying the primary disorder, assessing the degree of compensation, and calculating anion and delta gaps if metabolic acidosis is present.
3. Common causes of acid-base imbalances include respiratory acidosis/alkalosis from lung disease and metabolic acidosis/alkalosis involving the kidneys. Mixed disorders with both respiratory and metabolic components can also occur.
This document provides information about acute respiratory distress syndrome (ARDS), including its pathophysiology, clinical manifestations, diagnosis, treatment, nursing care, and complications. ARDS is a respiratory failure condition caused by lung injury and results in increased permeability of the alveolar-capillary membrane. It progresses through exudative, proliferative, and fibrotic phases. Treatment involves supportive care, mechanical ventilation, positioning strategies, and managing complications such as nosocomial pneumonia and renal failure.
This document discusses potassium homeostasis and hyperkalemia. It notes that potassium is mainly intracellular and its serum level is tightly regulated between 3.5-5 mEq/L. Mechanisms involve sodium-potassium pumps and renal excretion. Causes of hyperkalemia include reduced renal excretion, intracellular shifts, and inadequate aldosterone levels. Symptoms range from none to muscle weakness to arrhythmias. Treatment focuses on antagonizing cardiac effects, driving potassium intracellularly, and removing excess potassium.
Acute kidney injury (AKI) is a potentially life-threatening
syndrome that occurs primarily in hospitalized patients
and frequently complicates the course of critically ill
patient.
Acute Kidney Injury is is (abrupt) reduction in kidney functions as evidence by changed in laboratory values; serum creatinine, blood urea nitrogen(BUN)and urine output
Respiratory acidosis and alkalosis are acid-base disorders caused by problems with ventilation.
Respiratory acidosis occurs when Paco2 is elevated due to conditions that decrease ventilation like lung disease or muscle fatigue. It causes a decrease in pH but HCO3 rises in compensation. Chronic respiratory acidosis is treated by gradually lowering Paco2.
Respiratory alkalosis is caused by excessive ventilation lowering Paco2, seen in anxiety, pain, or drug effects. It increases pH but HCO3 falls as the kidneys compensate. Severe acute respiratory alkalosis can reduce blood flow and cause arrhythmias.
This document discusses acid-base balance and imbalances. It describes how arterial blood gases are used to assess acid-base status by measuring pH, partial pressure of carbon dioxide (PaCO2), and partial pressure of oxygen (PaO2). Respiratory acidosis occurs when PaCO2 is high due to decreased ventilation, while respiratory alkalosis is caused by increased ventilation and low PaCO2. Metabolic acidosis is due to bicarbonate deficit and metabolic alkalosis occurs when there is excess bicarbonate. The document provides details on causes, characteristics, diagnosis and treatment of these different acid-base imbalances.
This document discusses acid-base disorders. It begins by outlining the aims of examining pH, determining the primary disorder, calculating the anion gap, assessing compensation, and defining the disorder and treatment. It then provides introductions to pH, the Henderson-Hasselbalch equation, arterial blood gas analyses, and the anion gap. The document proceeds to discuss types of acid-base disorders including metabolic acidosis, respiratory acidosis, metabolic alkalosis, and respiratory alkalosis. It covers causes, symptoms, and treatments for each. An example case is presented of a patient with respiratory alkalosis.
This document discusses acid-base disorders and their classification. It provides details on:
- Metabolic acidosis is caused by loss of bicarbonate or addition of acid and affects tissues like the heart and brain. It is classified as normal or high anion gap.
- Metabolic alkalosis results from increased bicarbonate or stimuli for its reabsorption and is caused by loss of chloride, mineralocorticoid excess, or alkali administration.
- Respiratory acidosis is due to decreased ventilation relative to carbon dioxide production and causes tissue acidosis. Respiratory alkalosis is an increased ventilation relative to carbon dioxide production.
PRESENT: Acid base balance hossam (1).pptMbabazi Theos
This document discusses acid-base balance and interpreting arterial blood gas results. It begins by outlining the objectives of understanding acid-base physiology and the roles of pH, PaCO2, and bicarbonate. Normal values for arterial blood gases are defined. Causes, signs, and treatments of respiratory acidosis, respiratory alkalosis, metabolic acidosis, and metabolic alkalosis are reviewed. The document explains how to interpret an arterial blood gas report using a multi-step process of analyzing pH, PaCO2, and bicarbonate levels to determine if an acid-base imbalance is respiratory or metabolically-driven. Two case examples are provided and interpreted using the outlined steps.
The document discusses acid-base balance and disorders. It provides an introduction to acid-base chemistry and defines pH. It describes how the body regulates acids through buffer systems, respiration, and the kidneys. The document defines and discusses the causes, pathophysiology, diagnosis, and management of respiratory acidosis, respiratory alkalosis, metabolic acidosis, and metabolic alkalosis. Arterial blood gas analysis is described as a key test to evaluate acid-base status.
Respiratory alkalosis is caused by hyperventilation leading to excessive loss of carbon dioxide from the body. This alters the chemical equilibrium of carbon dioxide in the blood, increasing pH and decreasing carbon dioxide and bicarbonate levels. The kidneys can help regulate pH through reducing excretion of acids and bicarbonate reabsorption. Symptoms may include tingling in the extremities. Metabolic alkalosis is caused by increased bicarbonate in the blood due to loss of stomach acid or administration of bicarbonate solutions. This increases pH and bicarbonate while also increasing carbon dioxide. The body can compensate through reducing breathing rate and retaining more carbon dioxide.
This document defines and discusses acid-base disorders. It begins by defining terms like acidosis, alkalosis, and the normal ranges for pH, PCO2, and HCO3-. It then discusses the bicarbonate-carbonic acid buffer system and how acid-base disorders are classified based on initial chemical changes and compensatory responses. Etiologies of different acid-base disturbances are provided along with examples. Guidelines for interpreting arterial blood gases are outlined in a step-wise manner. Several case examples of acid-base disorders are then presented.
- Acid-base balance regulation involves multiple mechanisms working together to maintain pH within normal ranges, including buffer systems, respiration, and kidney function. Imbalances can occur due to metabolic or respiratory causes.
- Metabolic acidosis occurs when acids are produced faster than they can be removed, usually due to kidney problems. Symptoms include nausea and breathing changes. Treatment focuses on identifying and treating the underlying cause.
- Respiratory acidosis occurs when carbon dioxide levels are elevated due to decreased ventilation, leading to acidification of the blood. Causes include lung diseases and drugs. Symptoms range from restlessness to coma. Treatment aims to restore ventilation and address underlying issues.
An arterial blood gas test measures pH, oxygen, and carbon dioxide levels in blood from an artery. It provides information about oxygenation, ventilation, and acid-base levels. ABGs are useful for evaluating respiratory failure, severe illnesses that can cause metabolic acidosis like cardiac or liver failure, and conditions in ventilated patients or those undergoing sleep studies. Interpretation of ABG results involves considering pH, carbon dioxide, bicarbonate, and oxygen levels to determine if any acid-base imbalances exist and their underlying cause.
Acid and base Balance by Dr. Tehmas (Part 2)Tehmas Ahmad
This document discusses respiratory and metabolic acidosis and alkalosis. It defines each condition and describes their causes, symptoms, compensation mechanisms, and treatments. Respiratory acidosis is caused by high blood CO2 levels due to conditions that impair breathing. Metabolic acidosis is caused by bicarbonate deficit from things like diabetic ketoacidosis or alcohol poisoning. The document provides examples to demonstrate diagnosis of acid-base imbalances based on pH, pCO2 and bicarbonate levels.
This document provides information about arterial blood gas (ABG) analysis, including:
1. An ABG test measures pH, partial pressures of oxygen and carbon dioxide, bicarbonate, and base excess from an arterial blood sample. It is used to diagnose and manage oxygenation, ventilation, and acid-base balance issues.
2. The pH, PCO2, HCO3, and other values are involved in acid-base balance and are affected by respiratory and renal buffer systems. Respiratory acidosis, alkalosis, and other acid-base disorders have distinct causes, signs, and management approaches.
3. Interpreting an ABG involves following steps to determine if the primary disturbance
1. This document discusses acid-base disturbances and their classification, causes, clinical features, and treatment. It covers topics like metabolic acidosis, respiratory acidosis, metabolic alkalosis, and respiratory alkalosis.
2. Normal acid-base balance and electrolyte values are outlined. Case histories of patients with acid-base imbalances are presented, asking questions about identifying and explaining the nature of the disturbances.
3. Compensatory responses to primary acid-base disorders aim to restore pH balance. Anion gap and its role in identifying acid-base etiologies are explained. Causes, signs, and management of the main acid-base disorders are detailed.
1. The document discusses acid-base imbalances and compensation in the body. It defines pH, normal pH levels in body fluids, and how homeostasis of pH is tightly controlled.
2. Buffering systems help control pH, including extracellular and intracellular buffers like bicarbonate and proteins. Respiratory and renal systems also help regulate pH through controlling carbon dioxide and excreting hydrogen ions.
3. Various types of acid-base imbalances are described like metabolic acidosis, respiratory acidosis, metabolic alkalosis, and respiratory alkalosis. Causes, compensatory responses, and examples of each type of imbalance are provided.
This document provides information on interpreting arterial blood gas results to diagnose acid-base disorders. It discusses the four primary acid-base disorders: respiratory acidosis, metabolic acidosis, respiratory alkalosis, and metabolic alkalosis. Compensatory changes in response to these disorders are explained. The mechanisms by which the body controls acid-base balance through buffers, kidneys, and lungs are outlined. A stepwise approach to interpreting ABG results is provided to determine if there is acidemia/alkalemia, the primary disturbance, compensation, and high anion gap. Causes and characteristics of different acid-base disorders are described.
Respiratory acidosis and alkalosis as well as metabolic acidosis and alkalosis are discussed.
The key points are:
- Respiratory acidosis is defined as increased PaCO2 and decreased pH due to inadequate alveolar ventilation. Metabolic acidosis is defined as decreased HCO3 and pH.
- Causes, clinical manifestations, and management strategies are outlined for each condition.
- Mixed acid-base disorders can occur, and compensatory mechanisms aim to return pH to normal levels through respiratory and renal responses.
- A structured approach is recommended to diagnose acid-base disorders based on blood gas results, including evaluating pH, PaCO2, HCO3, and anion
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
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Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
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There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
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Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
2. INTRODUCTION
• Respiratory alkalosis is a condition where the amount of PaCO2 found in the blood
drops to a level below normal range.
• This condition produces a shift in the body's pH balance and causes the body's system
to become more alkaline (basic).
• caused due to deep breathing called hyperventilation.
• It is also caused due to disturbance in acid and bases balance due to alveolar
hypertension.
4. • In case of Respiratory Alkalosis more
amount of co2 is expelled out.
• Which in turn raises the level of
bicarbonate ion conc.
• In turn to compensate the level of hco3
ions
• Kidney excretes the excess of bicarbonate.
Cont…
5. How it is caused
• Alveolar hypertension leads to
decrease in PaCo2
• decrease in PaCo2 increases the
ratio of Bicarbonate conc. to
PaCo2
• which in turn increases pH level
of blood.
6. • Alveolar hypertension leads to decrease in PaCo2, so the
decrease in PaCo2 increases the ratio of Bicarbonate conc. to
PaCo2 and there by increases pH level of blood thus, term as
Respiratory Alkalosis.
• Alkalosis can be of two types –
1. Acute
2. Chronic
7. •Acute – In acute PaCo2 level is below lower limit of normal
and the serum pH is alkalemic.
•Chronic – In this the PaCo2 level is below the lower level
of normal but the pH level is relatively normal or near
normal.
9. PATHOPHYSIOLOGY
• Most cases of respiratory alkalosis reflects an increase in alveolar
ventilation.
• Decrease in PaCo2 equals to decrease in Alveolar ventilation.
• It Alkaline the body fluid.
• So decrease in Bicarbonate Conc. that reduces the impact of
Hypocapnia on systemic acidity.
10. • Two types of adaptations Acute
chronic
1. Acute – It is completed within 5 to 10 min of Hypocapnia
Originates principally from Alkaline Titration of the body non
bicarbonate buffers.
2. Chronic – It requires 2 to 3 days of sustained Hypocapnia completion.
Originates from down regulation of renal acidification mechanism
that results in decrease in urinary net acid excretion and decrease in rate of
renal bicarbonate reabsorption.
11. SIGNS AND SYMPTOMS
• Symptoms and signs depend on the rate and degree of fall in PCO2.
Acute respiratory alkalosis causes light-headedness, confusion,
cramps, and syncope. Mechanism is thought to be as a result of
change in cerebral blood flow and pH. Tachypnea or hyperpnea is
often the only sign; carpopedal spasm may occur in severe cases due
to decreased levels of ionized calcium in the blood (driven inside
cells in exchange for hydrogen ion [H+]).
• Chronic respiratory alkalosis is usually asymptomatic and has no
distinctive signs.
12. APPROACH
Respiratory alkalosis may produce a variety of clinical manifestations, ranging
from mild symptoms to fatal outcome, due to direct effects or secondary electrolyte
disturbances.
Respiratory alkalosis can be classified clinically into 3 categories:
1. As a component of disease processes
2. Induced accidentally
3. Induced deliberately (therapeutic).
• Accidental respiratory alkalosis develops as a consequence of inappropriate settings
of mechanical ventilation or associated with extracorporeal membrane oxygenation
(ECMO).
13. ARTERIAL BLOOD GAS (ABG) ANALYSIS
Value Normal range Clinical significance
pH 7.35-7.45 The pH tells you if your patient is acidotic or
alkalotic. It is a measurement of the acid content or
hydrogen ions [H+] in the blood. A high pH
indicates a lower concentration of hydrogen ions
(alkalosis).
PaCO2 35-45 mm Hg The PaCO2 level is the respiratory component of
the ABG. It is a measurement of carbon dioxide
(CO2) in the blood and is affected by CO2 removal
in the lungs. A low PaCO2 level indicates alkalosis.
14. ARTERIAL BLOOD GAS ANALYSIS
• In summary, if pH > 7.45 and PaCO2 < 35mmHg and the HCO3-
level is normal, the patient has respiratory alkalosis.
15. CAUSES /ILLNESS
The main causes of Respiratory Alkaloisis or Hyperventillation are as
follows:-
a) Temperature increase in body(Fever)
b) Aspirin Toxicity
c) Controlled mechanical ventillation
d) Hyperventillation
e) Hysteria
f) Pain
g) Neurological injuries
h) Embolism
i) Asthma
16.
17. • Many patients with hyperventillation syndrome appear anxious and
are frequently tachycardic.
understandably, tachypnea is a frequent finding.
• In acute hyperventillation, chest wall movement and breathing rate
increases. In patients with chronic hyperventillation, these physical
finding may not be as obvious.
• The hyperventillation syndrome can mimic many conditions that are
more serious. Symptoms may include paresthesias, circumoral
mumbness ,chest pain or tightness, dyspnea and tetany.
18. • Cardiovascular effects of hypocapnia in healthy and alert patients are minimal, but
in patients who is anesthetized , critically ill , or receiving mechanical ventillation ,
the effect can be more significant. Cardiac output and systemic blood pressure may
fall as a result of the effects of sedation and positive pressure ventillation on
venous return systemic vascular resistence and heart rate.
19. • Cardiac rhythm disturbance may occur because of increased
tissue hypoxia related to the leftward shift of the
hemoglobin-oxygen dissociation curve.
20. SUMMARY
CNS causes are as follows:-
Pain,Hyperventillation,Anxiety,Panicdisorders,Psychosis,Fever,Cerebrovascularacci
dent, Meningitis, Encephalitis, Tumor, Trauma etc.
Hypoxic-related causes are as follows:-
High altitude and right to left shunts
Drug- related causes are as follows:-
Progesterone,Methylxanthine toxicity, Salicylic toxicity, Catecholamines,
Nicotine etc.
Endocrine related causes are as follows:-
Pregnancy and hyperthyroidism
21. Pulmonary causes are as follows:-
Pneumothorax, Pneumonia, Pulmonary edema, Pulmonary embolism, Aspiration,
Interstitial lung diseases, asthma, Emphysema, Chronic bronchitis etc.
Miscellaneous causes are as follows :-
Sepsis, Severe anemia, Hepatic failure, Mechanical ventillation, Heat exhaustion,
Recovery phase of metabolic acidosis, Congestine heart failure etc.
22. • Breathe into a paper bag
• Fill the paper bag with carbon dioxide by exhaling into it.
• Breathe the exhaled air from the bag back into the lungs.
• Repeat this several times.
• Restrict oxygen intake into the lungs
• by closing one of the nostrils, so the lesser amount of oxygen enters the lungs
for mankind the co2 and o2 conc equal.
Treatment
23.
24. • High altitude sickness is treated with acetazolamide 250mg 12 hourly,
Dexamethasone 4mg 6 hourly, oxygen therapy and descent to lower altitude
in severe cases.
• For critically ill patients on mechanical ventilation with respiratory alkalosis,
tidal volume and respiratory rate needs to be decreased with adequate pain
control.
• Sedatives and antidepressants should not be used in cases of respiratory
alkalosis.
25. REFERENCES
• Berend K, de Vries AP, Gans RO. Physiological approach to assessment of acid-
base disturbances. N Engl J Med. 2014;371:1434-1445.
• Androgue HJ, Madias NE. Management of life-threatening acid-base disorders:
second of two parts. N Engl J Med. 1998;338:107-111.
• Byrne, G. (2015). MedScape. Nursing Standard, 29(51), 29-29.
doi:10.7748/ns.29.51.29.s34