Acid-base balance is one of the most important medical topics for medical students and health staff

1. Acid base balance
ABG
By
Aymen Alhasni

7. Normal Value
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PH = 7.40 (7.35 – 7.45)
PaCo2 = 40 (35 – 45) mmHg
HCO3= 25 (22– 26) mmHg
PaO2 = 80– 100 mmHg
Sao2 = 92 – 96 % Cl = 100 mmol/L
Anion Gap: 12 ±2 ( Na – (HCO3 +Cl)
Delta Gap: 6 ( AG – HCO3 )
Cl/HCO3 Gap: 5 (Cl - HCO3 )

8. Acid. Alkaline
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PH. 7.35 - 7.45
PCO2. 45. - 35
HCO3 22 - 28
. HCO3. Metabolic Acidosis
HCO3. Metabolic Alkalosis
PCO2. Respiratory Acidosis
PCO2 . Respiratory Alkalosis

10. 3 Steps
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Step 1: Look at: pH : Acidemia or alkalemia
Step 2: Look at: PaCO2/HCO3: Resp./Met.
Step 3: Is there Expected Compensa on

11. PH= 7.35 _7.45 paco2 =35_45 Hco3 =22_28
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PH =7.49
HCO3 = 27
Paco2 = 28

12. PH= 7.35 _7.45 paco2 =35_45 Hco3 =22_28
• Uncompensated RESPIRATORY Alkalosis

13. PH= 7.35 _7.45 paco2 =35_45 Hco3 =22_28
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PH. 7.21
HCO3. 15
paco2. 40

14. PH= 7.35 _7.45 paco2 =35_45 Hco3 =22_28
• Uncompensated Metabolic Acidosis

15. PH= 7.35 _7.45 paco2 =35_45 Hco3 =22_28
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PH. 7.50
HCO3. 34
paco2. 41

16. PH= 7.35 _7.45 paco2 =35_45 Hco3 =22_28
• Uncompensated Metabolic Alkalosis

19. Types of compensation
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Par al
complete
mixed

20. Partial

21. •
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PH. 7.21
HCO3. 15
paco2. 40
PH= 7.35 _7.45 paco2 =35_45 Hco3 =22_28

22. PH= 7.35 _7.45 paco2 =35_45 Hco3 =22_28
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Par al compensa on RESPIRATORY Alkalosis
Ph. 7.50
pco2. 25
Hco3 19
Na. 130
cl. 80

23. complete

24. complete

25. complete
• Compensated RESPIRATORY Alkalosis

26. mixed

27. mixed

28. mixed
• Mixed Metabolic Respiratoty Alkalosis

29. Anion Gap
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Anion Gap: 12 ±2 ( Na – (HCO3 + Cl)
PH 7.30
pco2. 60
Hco3 30
Na 135
cl 100

30. PH= 7.35 _7.45 paco2 =35_45 Hco3 =22_28
• RESPIRATORY Acidosis with low AG

31. Thank you
The end