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Arterial Blood Gases

Comparison of Alkalosis and Acidosis

Normal pH 7.35-7.45
Normal PCO2 35-45
Normal HCO3 22-26
Alkalosis pH >7.45
Acidosis pH <7.35
PCO2 >45 respiratory acidosis
PCO2 <35 respiratory alkalosis
HCO3 >26 metabolic alkalosis
HCO3 <22 metabolic acidosis
If PCO2 between 35-45 then No respiratory problems and no respiratory compensation for metabolic problems
if HCO3 between 22-26 then No primary metabolic problems and the kidneys are not compensating for respiratory problems
If PCO2 >45 then Respiratory retention of CO2 to compensate for metabolic alkalosis
If PCO2 <35 then Respiratory retention of CO2 to compensate for metabolic acidosis
If HCO3 <22 then Kidneys are attempting to compensate for respiratory alkalosis
If HCO3 >26 then Kidneys are attempting to compensate for repiratory acidosis
Causes of respiratory alkalosis Alveolar hyperventilation
Causes of respiratory acidosis Alveolar hypoventilation
Causes of metabolic alkalosis Bicarbonate ingestion, vomiting, diuretics, steroids, adrenal disease
Causes of metabolic acidosis Diabetic, lactic, or uremic acidosis, prolonged diarrhea
Signs/Symptoms of respiratory alkalosis Dizziness, syncope, tingling, numbness, early tetany
Signs/Symptoms respiratory acidosis Early: anxiety, restlessness, dyspnea, headache; Late: confusion, somnolence, coma
Signs/Symptoms metabolic alkalosis Vague symptoms: weakness, mental dullness, possible early tetany
Signs/Symptoms metabolic acidosis Secondary hyperventilation (Kussmaul's breathing), nausea and vomiting, cardiac dysrhythmias, lethargy, and coma
7.35- 7.45 normal ph
35 -45 normal CO2
22-26 normal HCO3
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