Acid Base Clinical Correlation Flashcards
pH is determined by
- ratio of serum bicarbonate to PCO2
compensatory mechanism for metabolic acidosis
- immediately hyperventilation
compensatory mechanism for metabolic alkalosis
- immediate hypoventilation
compensatory mechanism for respiratory acidosis
- increased renal HCO3 reabsorption
compensatory mechanism for respiratory alkalosis
- decreased renal HCO3 reabsorption
ways to determine acid/base problems
- look at pH
- look at CO2 to determine primary disorder
- determine if compensation is appropriate
when is the only time you calculate anion gap
- when patient has metabolic acidosis
order for ABG
- pH/PCO2/PO2/bicarb
normal CO2 range
- 40
normal bicarb range
- 24
respiratory alkalosis caused by
- hyperventilation
respiratory acidosis cased by
- hypoventilation
indications for invasive positive pressure ventilation
- hypoxemia respiratory failure
- hypercarbic respiratory failure
- unstable airway
how invasive positive pressure ventilation helps in hypoxemic respiratory failure
- improves gas exchange by improved V/Q matching by decreasing shunt
- reduces work of breathing and reduces oxygen consumption by respiratory muscles
how invasive positive pressure ventilation helps in hypercarbic respiratory failure
- reduces work of breathing and prevents respiratory muscle fatigue or speeds recovery when fatigue is present
- maintains adequate alveolar ventilation
mechanical ventilation modes
- volume
- pressure
- mandatory
- non mandatory
how volume mode works
- set tidal volume to be delivered with each breath
- ventilator uses enough pressure to achieve
how pressure mode works
- set pressure to be given with each breath
- tidal volume will be variable
how mandatory mode works
pressure or volume mode?
- set number of mandatory breaths per minute to be delivered by the ventilator
- both
how non-mandatory mode works
pressure or volume mode?
- no guaranteed respiratory rate
- every breath is patient initiated
- pressure only
what do we adjust for hypoxemia
- adjust FiO2 or PEEP (positive end expiratory pressure)
what do we adjust for hypercarbia
- increase minute ventilation (tidal volume and respiratory rate)
- give BiPAP to increase inspiratory pressure and tidal volume
