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    Blood Gas Analysis

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    EvanDwiyana
    The document provides information about blood gas analysis and the steps in acid-base classification. It discusses classifying acid-base disturbances based on pH, PaCO2, HCO3, BE and determining whether the primary process is respiratory or metabolic. It also covers evaluating compensation and the degree of compensation. Normal ranges for arterial and venous blood gases are provided. Several case examples are presented to demonstrate classification of acid-base status.

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    Blood Gas Analysis

    Uploaded by

    EvanDwiyana
    116 views27 pages
    The document provides information about blood gas analysis and the steps in acid-base classification. It discusses classifying acid-base disturbances based on pH, PaCO2, HCO3, BE and determining whether the primary process is respiratory or metabolic. It also covers evaluating compensation and the degree of compensation. Normal ranges for arterial and venous blood gases are provided. Several case examples are presented to demonstrate classification of acid-base status.

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    The document provides information about blood gas analysis and the steps in acid-base classification. It discusses classifying acid-base disturbances based on pH, PaCO2, HCO3, BE and determining whether the primary process is respiratory or metabolic. It also covers evaluating compensation and the degree of compensation. Normal ranges for arterial and venous blood gases are provided. Several case examples are presented to demonstrate classification of acid-base status.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    116 views27 pages

    Blood Gas Analysis

    Uploaded by

    EvanDwiyana
    The document provides information about blood gas analysis and the steps in acid-base classification. It discusses classifying acid-base disturbances based on pH, PaCO2, HCO3, BE and determining whether the primary process is respiratory or metabolic. It also covers evaluating compensation and the degree of compensation. Normal ranges for arterial and venous blood gases are provided. Several case examples are presented to demonstrate classification of acid-base status.

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    of 27

    BLOOD GAS

    ANALYSIS

    Hasanul Arifin
    Departemen Anestesiologi dan Reanimasi

    FKUSU RSUP. H. Adam Malik Medan


    Apa yang dibaca ?

    pH, PaCO2, BE
    HCO3, PaO2,
    SaO2

    Hasanul-2004
    STEPS IN ACIDS BASE
    CLASSIFICATION

    1. pH Classification
    2. PaCO2 Classification
    3. Metabolic Classification
    4. Compensation Evaluation
    5. Complete Acid-Base Classification
    Hasanul-2004
    pH Classification

    Classification pH
    Normal 7.35-7.45
    Acidosis < 7.35
    Alkalosis >7.45
    Hasanul-2004
    Classification of Laboratory
    Respiratory Acid-Base Component

    Classification PaCO2 (mmHg)


    Normal Resp.Component 35-45
    Respiratory Acidosis >45
    Respiratory Alkalosis <35

    Hasanul-2004
    Classification of Laboratory
    Metabolic Acid-Base Component

    Classification BE HCO3
    Normal Metab.Component 02 242
    Metabolic Acidosis < -2 <22
    Metabolic Alkalosis > +2 >26
    Hasanul-2004
    Langkah Langkah
    Baca pH normal, acidosis, alkalosis
    Lihat PaCO2 atau BE, mana yg searah dengan pH
    Bila PaCO2 yang searah respiratorik sebagai
    proses primer
    Bila BE yang searah metabolik sebagai proses
    primer
    Bila proses primer sudah diketahui, lihat dimana
    posisi komponen yg lain :
    Bila berlawanan proses kompensasi
    Bila searah proses ganda
    Bila posisi normal belum atau tidak ada proses
    kompensasi

    hasanul-2004
    ACIDOSIS ALKALOSIS
    7,35 pH 7,45
    45 PaCO2 35
    -2 BE +2
    22 HCO3 26
    Eddy Rahardjo1990/Hasanul-2004
    pH : 7.28, PaCO2 : 40, BE : -10

    ACIDOSIS ALKALOSIS
    7.28 7,35 pH 7,45
    45 40 2
    PaCO 35
    -10 -2 BE +2
    22 HCO3 26
    hasanul-2004

    Acidosis metabolik tanpa kompensasi


    pH : 7.32, PaCO2 : 55, BE : +1

    ACIDOSIS ALKALOSIS
    7.32 7,35 pH 7,45
    55 45 PaCO2 35
    -2 +1
    BE +2
    22 HCO3 26
    hasanul-2004

    Acidosis respiratorik tanpa kompensasi


    pH : 7,50 ; PaCO2 : 30 ; BE : -2 ;

    ACIDOSIS ALKALOSIS
    7,35 pH 7,45 7,50
    45 PaCO2 35 30
    -2 BE +2
    22 HCO3 26
    Alkalosis respiratorik tanpa kompensasi
    hasanul-2004
    pH : 7,55 ; PaCO2 : 30 ; BE : +5 ;
    ACIDOSIS ALKALOSIS
    7,35 pH 7,45 7,55
    45 PaCO2 35 30
    -2 BE +2 +5
    22 HCO3 26
    Hasanul-2004

    Alkalosis respiratorik dan metabolik


    (proses ganda)
    Steps in Evaluation and Classification of
    Acid-Base Compensation

    1. Evaluate for the presence of compensation


    2. Determine the probable primary problem
    3. Classify the degree of compensation

    Hasanul-2004
    Determination of the
    primary problem

    pH 7.40-7.45 Alkalosis is primary


    Acidosis is compensatory

    pH 7.35-7.40 Acidosis is primary,


    Alkalosis is compensatory

    Hasanul-2004
    Classification of degree of
    Compensation

    pH Degree of compensation
    7.35-7.45 Complete
    <7.35 Partial
    >7.45 Partial

    Hasanul-2004
    pH : 7,48 ; PaCO2 : 30 ; BE : -6 ;

    ACIDOSIS ALKALOSIS
    7,35 pH 7,45 7,48
    45 PaCO2 35 30
    -6 -2 BE +2
    22 HCO3 26
    Alkalosis respiratorik dgn kompensasi parsial
    hasanul-2004
    pH : 7.32, PaCO2 : 30, BE : -10

    ACIDOSIS ALKALOSIS
    7.32 7,35 pH 7,45
    45 PaCO2 35 30
    -10 -2 BE +2
    22 HCO3 26
    hasanul-2004

    Acidosis metabolik dgn kompensasi parsial


    pH : 7.38, PaCO2 : 30, BE : -10

    ACIDOSIS ALKALOSIS
    7,35 7,38
    pH 7,45
    45 PaCO2 35 30
    -10 -2 BE +2
    22 HCO3 26
    Hasanul-2003

    Acidosis metabolik dgn kompensasi penuh


    pH : 7,43 ; PaCO2 : 30 ; BE : -6 ;

    ACIDOSIS ALKALOSIS
    7,35 pH7,43 7,45
    45 PaCO2 35 30
    -6 -2 BE +2
    22 HCO3 26
    Alkalosis respiratorik dgn kompensasi penuh
    Hasanul-2003
    CLASSIFICATION of PaO2
    PaO2 (mmHg)
    CLASSIFICATION Adult Newborn
    Hyperoxemia >100 >90
    Normoxemia 80-100 60-90
    Mild hypoxemia 60-79 50-59
    Moderate hypoxemia 45-59 40-49
    Severe hypoxemia <45 <40
    Hasanul-2003
    Severity of Generalized Acid-Base
    disturbances
    pH Degree of Impairment
    <7,20 Severe Acidosis
    7,20-7,29 Moderate Acidosis
    7,30-7,34 Mild Acidosis
    7,35-7,45 Normal pH
    7,46-7,50 Mild Alkalosis
    7,51-7,55 Moderate Alkalosis
    >7,55 Severe Alkalosis
    Hasanul-2003
    Normal Arterial Gases
    Parameter Values
    pH 7,35-7,45
    PaCO2 35-45 mmHg
    PaO2 80-100 mmHg
    SaO2 98-100%
    Hasanul-2003
    Normal mixed venous gases

    Parameter Values
    pH 7,38
    PaCO2 48 mmHg
    PaO2 40 mmHg
    SaO2 75%
    Hasanul-2003
    No. pH PaCO2 HCO3 PaO2 Classification
    1. 7,58 20 19 63
    2. 7,44 52 34 28
    3. 7,21 66 26 47
    4. 7.44 31 20 111
    5. 7,60 28 27 59
    6. 7,50 50 37 75
    7. 7,41 42 25 229
    8. 7,52 41 32 49
    9. 7,44 28 35 87
    10. 7,44 35 23 97
    Hasanul-2003
    No. pH PaCO2 BE PaO2 Classification

    1. 7.32 30 -10 58
    2. 7.52 34 +4 32
    3. 7.36 32 -4 145
    4. 7.42 30 -5 90
    5. 7.20 50 -9 60
    6. 7.20 80 +2 90
    7. 7.55 25 0 72
    8. 7.34 30 -9 41
    9. 7.37 56 +4 57
    10. 7.40 38 -2 350
    Hasanul-2003
    Kam shia
    Terima Kasih

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