Blood gases, pH & buffer systems
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| Respiratory acidosis | lower pH and an increased PCO2 and is due to respiratory depression
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| Respiratory alkalosis, | raised pH and a decreased PCO2,
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| due to over ventilation caused by hyperventilating, pain, emotional distress, or certain lung diseases that interfere with oxygen exchange. | repiratory alkalosis
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| Metabolic acidosis | a lower pH and decreased HCO3-
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| blood is too acidic on a metabolic/kidney level | metabolic acidosis
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| Metabolic alkalosis | elevated pH and increased HCO3-
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| seen in hypokalemia, chronic vomiting (losing acid from the stomach), and sodium bicarbonate overdose. | metabolic alkalosis
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| pH decreased; HCO3- decreased | Metabolic acidosis
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| pH increased; HCO3- increased | metabolic alkalosis
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| pH decreased; pCO2 increased | Respiratory acidosis
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| pH increased; pCO2 decreased | Respiratory alkalosis
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| pCO2 | pressure due to carbon dioxide in the blood
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| pO2 | measure of the pressure of the oxygen dissolved in the blood
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| O2 saturation | represents the proportion of oxygenated hemoglobin compared to the total functional hemoglobin
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| reference range for pH | 7.35-7.45
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| reference range for pCO2 | 40 mm hg
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| reference range for HCO3- | 24 mmol/L
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| reference range for total CO2 content | 23-27 mmol/L
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| reference range for pO2 | 80-110 mmol/L
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| reference range for SO2 | >95% saturation
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| reference range for O2Hb | >95%
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| carbonic acid | H2CO3
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| bicarbonate | HCO3- anion
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| Oxygen content | sum of the oxygen bound to hemoglobin as O2Hb and the amount dissolved in the blood
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| Oxygen saturation SO2 | represents the ratio of oxygen that is bound to the carrier protein(hemoglobin) compared with the total amount that the hemoglobin could bind
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| Base Excess | theroretical amount of titratable acid or base required to return the plasma pH to 7.40 at a pCO2 of 40mm Hg at 37C
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| Metabolic | refers to all acids and metabolites other than carbonic acid and is measured as HCO3-
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| To maintain a stable pH | plasma proteins and plasma buffers combine with the freed H+
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| Fractional hemoglobin FO2Hb | ratio of the concentration of oxyhemoglobin to the concentration of total hemoglobin (ctHb)
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| Hemoglobin-oxygen(binding)capacity | maximum amount of oxygen that can be carried by hemoglobin in a given quantity of blood
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| PO2 definition | partial pressure of oxygen
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| PCO2 definiton | partial pressure of carbon dioxide
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| pH | represents the negative or inverse log of the hydrogen ion concentration
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| Hypercarbia | abnormally increased arterial carbon dioxide tension
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| Acidemia | a pH of blood less than reference range
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| Alkalemia | a blood pH greater than the reference range
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| Respiratory | pertains to the lungs and is associated with an increase or decrease in carbonic acid & is measured as pCO2
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| Positive value base excess | non respiratory alkalosis
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| Negative value base excess | non respiratory acidosis
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| Non respiratory (other name) | Metabloic
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| Acid | substance that can yield a hydrogen ion(h+) or hydrogen ion when dissolved in water
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| Base | Substance that can ield hydroxyl ions (OH-)
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| Buffer | combination of a weak acid or weak base and its salt
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| System that resists change in pH | Buffer
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| Regulation of H+ | bodys first line of defense against extreme changes in H+ concentration is the buffer system present in all body fluids
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| Carbon dioxide | the end product of most aerobic metabolic processes
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| Chloride shift | maintain electroneutrality, diffuses into the cell
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| electroneutrality | same number of positively and negatively charged ions on each side of the red cell membrane
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| Acidosis | pH below 7.35
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| Alkalosis | pH above 7.45
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| Bicarbonate buffering system | open system
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| lungs | participate rapidly in the regulation of blood pH through hypoventilation or hyperventilation
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| Control the bicarbonate concentration | Kidneys ( nonrespiratory or metabolic component
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| When arterial blood from a normal patient is exposed to room air | pCO2 increases & PO2 decreases
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| Normal ratio of carbonic acid to bicarbonate in arterial blood | 1:20
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| at a pH of 7.10 the H concentration is equal to... | 80 nmol/L
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| The anticoagulant of choice for arterial blood gas measurments | Lithium heparin in the dry state
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| Carbonic acid concentration in blood plasma equals | 0.0307 mmol-1 mn hg-1 times the pCO2 value in mmhg
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| Q. bicarbonate leaves the rbcs and enters plasma through an exchange mechanism with (BLANK) to maintain electroneutrality | A. Chloride
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| Q. pH 7.48 ;pCO2 54 mm; HCO3- 38mmol/L | A. Compensated nonrespiratory alkalosis
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| Q. Oxygen content in blood reflects | A. pO2 value
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| Q. pH 7.37 ; pCO2 75mm hg ; HCO3- 37 mmol/L | A. Compensated respiratory acidosis
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| Q. Hemoglobin oxygen binding capacity for a blood sample that is 100% saturated with O2 and has a total hemoglobin calue of 12g/dL is approximatly | A. 17 mL O2/dL
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| Q. Hypoventilation can compensate for | A. Non respiratory acidosis
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| Respiratory Alkalosis signs & symptoms | Dizziness, syncope, tingling, numbness, early tetany
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| Respiratory acidosis signs and symptoms | Early: anxiety, restlessness, dyspnea, headache
Late: confusion, somnolence, coma
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| Metabolic alkalosis signs and symptoms | weakness, mental dullness
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| Metabolic acidosis signs and symptoms | Secondary hyperventilation, nausea, lethargy, coma
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| Respiratory alkalosis causes | Alveolar hyperventilation
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| Respiratory acidosis causes | Alveolar hypoventilation
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| Metabolic alkalosis causes | Bicarbonate ingestion, vomiting, diuretics, steroids, adrenal disease
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| Metabolic acidosis causes | Diabetic, lactic, or uremic acidosis, prolonged diarrhea
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| ^ pH ; low pCO2 ; decreased HCO3 | metabolic compensation
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| ^ pH ; low pCO2 ; normal HCO3 | no compensation
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| ^ pH; ^ HCO3 ; elevated pCo2 | respiratory compensation
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| ^ pH; ^ HCO3; normal pCO2 | no compensation
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| metabolic compensation | low pH; ^ pCO2 ;increased HCO3
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| No compensation | low pH; ^ pCO2; normal HCO3
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| Respiratory compensation | low pH; low HCO3; decreased pCO2
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| Acidosis metabolic -no compensation | low pH; low HCO3; normal pCO2
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| Metabolic acidosis potassium ( increased or decreased) | Increased(metabolic)
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| Metabolic alkalosis potassium (increased or decreased) | Decreased(metabolic)
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| Respiratory acidosis potassium ( increased or decreased) | Increased ( respiratory)
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| Respiratory alkalosis potassium (increased or decreased) | Decreased ( respiratory)
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| disorders where pCO2 are normal | Metabolic alkalosis and acidosis
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| Shift in curve to the left | results in easier binding of oxygen to haemoglobin, but decreased ability to dissociate from haemoglobin and move to the tissues. Can cause hypoxia
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| common causes of left shifts of the curve | alkalosis, hypocapnia, hyperthermia
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| Shifts in curve to the right | Causes oxygen to associate poorly with haemoglobin but dissociate more readily at a tissue level. this can easily lead to tissue hypoxia from poor arterial oxygenation
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| Common causes of right shifts of the curv25`e | Acidosis, hypercapnia, hyperthermia
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