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27 Cards in this Set
- Front
- Back
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Normal PH
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735-745
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Normal Arterial PaCO2
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35-45
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Normal Arterial Bicarb
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22-26
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Normal Arterial PaO2
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80-100
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Normal Base Excess
What does it mean? |
-2 to +2
Amount of H+ ions that would be required to return the pH of the blood to 7.35 if the pCO2 were adjusted to normal. Excess or Insufficient level of bicarbonate (A negative base excess indicates a base deficit in the blood.) A negative base excess is equivalent to an acid excess. A value outside of the normal range (-2 to +2 mEq) suggests a metabolic cause for the abnormality. |
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Aveolar Oxygen Concentration
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[(Barometric Pressure - Water Pressure) x FiO2]-[pCO2/0.8]
= [(760-47) x ?] - [?/0.8] |
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pH <7.35
PCO2 > 45mmHg |
Respiratory Acidosis
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Respiratory Acidosis
Why? |
breathing slow, retaining CO2
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Causes of Respiratory Acidosis?
Treatment? |
1 Depressed Medullary Center
2 Obs Upper Airway 3 Extra Pulmonary 4 Impaired alveolar gas exchange 5 Acute compensatory Tx underlying and ventilate |
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How do I differentiate them?
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A-a gradient
<20: Extrinsic pulmonary factors >20: Intrinsic pulmonary factors (Shunt, V/Q and Diffusion problem) |
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Primary respiratory acidosis, Acute vs Chronic?
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Acute: for every 10mmHg increased CO2, H2CO3 increases 1mmEq (1-3d)
Chronic: for every 10mmHg increased CO2, H2CO3 increases 3mmEq.(wks) |
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Depressed Medulary Center
Why? |
drugs, central sleep apnea,
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Extrapulmonary
Why? |
Impaired respiratory muscles, chest wall dysfunction or chronic mountain sickness
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Obstructed Airway
Why? |
Asthma, Bronchiectasis, COPD (emphysema, chronic bronchitis)
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Impaired alveolar gas exchange
Why? |
Fibrosis, ARDS
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pH >7.45
PCO2 <40mmHg? |
Metabolic acidosis with compensation, you need to check anion gap
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What is normal anion gap?
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4-12
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>12 anion gap
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MUDPILES
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MUDPILES stands for?
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Methanol
Uremia Diabetic Ketoacidosis Paraldehyde INH Lactic acidosis Ethylene glycol Salicylates |
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Metabolic Acidosis with anion gap greater than 12.
What do you worry about? |
Methanol - Blindness, give alcohol if need be.
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Metabolic Acidosis with anion gap >12.
What do you do next? |
Osmotic gap: measured osm - calc osm
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cal osm?
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= 2Na + BUN/2.8 + Gluc/18
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what will the osmotic gap be for EtOH? MetOH? Ethylene glycol?
tx for each |
>20
Tx for all Fomepizole, Hemodialysis, bicarb |
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Normal Venous PaCO2
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38-52
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Normal Venous Bicarb
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19-25
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Normal Venous PaO2
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28-48
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Normal Venous SaO2
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50-70
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