By Iain Hennessey, Alan Japp
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Extra resources for Arterial Blood Gases Made Easy
INTERPRETING ACID·IASE STATUS • Usc the flow chart opposite to broadl}' classify acid-base status. 'Tl the differential diagnosis. Anion Gap"" (Na + K) - (el + HC03) Normal =10 - 18mmol/l • U the precise acid-base derangement is not immOOiately clear (ego middle column) then remember the followmg points: Always consider the clinical conlexl when interpreting acid-base status. Metabolic compensation takes days 10 occur, re>piratory compensaoon takes minutes. Overcompensation does not occur.
E breakdown of fats and SUgMS for energy generates ~ which, when dis:dvro In blood, fOf"DlS carbonic acid (see Box on page 211). st, therefore, be rcmovL'd. to maintain normal blood pi!. What removes H+ ion. ,1 pressure of carbon dioxidt> in our blood, is determinoo by alvL'Olar vCl1tllo:ation. "CSSary. 10 maintain PlIC'O;z within oormallimifs. ies is in the form of COz, so it is our lungs that excrete the vast majority of the o:aud load. Renal (mefobollc) mechanisms The kidneys art' r(>$poru;ible for eXcrelmg rnmbolic acids.
IlIMI::i III ii n ~~. i bv aJvl'\llar h,,~rvmtilatlon 'rima.... ,U"t'li UKlude. us (hroni< ao U\ respiratory CKido~. ''"'Cs l