[醫(yī)學(xué)]血氣分析課件-資料下載頁
2024-10-16 17:57本頁面
【正文】 ng Winter’s formula: Expected PaCO2 = [ ( x 12) + (8 177。 2) ] x = – kPa The PaCO2 falls within this range ?SIMPLE METABOLIC ACIDOSIS What is the anion gap? Click to continue 2021/11/10 38 Example 6. pH PaCO2 PaO2 HCO3 12 Base excess 10 Na+ 135 Cl 99 What is the anion gap? = [Na+] – ( [Cl] + [HCO3] ) = [135] – ( 99 + 12 ) Na = 24 mmol/l ? There is an anion gap acidosis due to accumulation of anic acids caused by diabetic ketoacidosis Click to continue 2021/11/10 39 Example 6. pH PaCO2 PaO2 HCO3 12 Base excess 10 Na+ 135 Cl 99 Corrected bicarbonate = 24 mmol/l The PaCO2 falls within the expected range SIMPLE METABOLIC ACIDOSIS。 NO OTHER DISTURBANCE Return to examples 2021/11/10 40 Example 7. A 70 year old man presents with a 3 day history of severe vomiting. Here is his ABG on room air. 1. Is he hypoxic? pH PaCO2 PaO2 HCO3 38 Base excess +8 Saturation 96% Click to continue 2021/11/10 41 Example 7. NO. This is a normal PaO2 for a patient this age breathing room air 2. Is there an acid base or ventilation problem? pH PaCO2 PaO2 80 HCO3 38 Base excess +8 Saturation 96% Click to continue 2021/11/10 42 Example 7. YES. pH PaCO2 PaO2 HCO3 38 Base excess +8 Saturation 96% Click to continue 2021/11/10 43 Example 7. There is: ? Alkalosis ? PaCO2 is elevated ? ? NOT respiratory alkalosis Look at [HCO3] ? [HCO3] is increased ? Base excess is positive ? METABOLIC ALKALOSIS pH PaCO2 PaO2 HCO3 38 Base excess +8 Saturation 96% Click to continue 2021/11/10 44 Example 7. 3. Is there respiratory pensation? Expected PaCO2 = ? kPa per 10 mmol/l ? in HCO3 = + ( x ([ 38 – 24 ]/10)) = ? CONSISTENT WITH SIMPLE METABOLIC ALKALOSIS pH PaCO2 PaO2 HCO3 38 Base excess +8 Saturation 96% Return to examples 2021/11/10 45
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