Blood Gas Analysis Flashcards
T/F: H+ is constantly being produced by metabolism.
True
What organs are involved in acid-base homeostasis?
Lungs, Kidney, Liver, GIT
What are the chemical buffers in the body?
Extracellular: HCO3-
Intracellular: Phosphate, proteins (slower acting)
How long does renal compensation take?
Hours to days
How long does respiratory compensation take?
Minutes (increase or decrease RR)
What are measured in Blood gas analysis?
- pH
- PaCO2
- PaO2
What are calculated in blood gas analysis?
- HCO3-
- BE
- O2 content (CaO2)
What is assessed for respiratory component?
PaCO2
What is assessed for metabolic component?
BE or HCO3
Normal pH
7.35-7.45
Normal HCO3-
24+/-4 mEq/L
Normal PaCO2
35-45 mmHg
Herbivores produce more……
HCO3-
Normal Cat values
HCO3- ~20mEq
PsCO2 ~30mmHg
Base Excess
Refers to an excess or deficit in the amount of base present in the blood
The differene of HCO3- from normal value if PaCO2 and temp were normalized
Positive Base excess
Metabolic alkalosis
Negative Base excess
Metabolic acidosis
aka base deficit
Anion Gap
The amount of positive and negative ions should be equal, the difference is represented in unmeasured ions
Main positive ions
Na and K
Main negative ions
Cl and HCO3
Normal Anion Gap
16+/-4 mEq/L
What causes elevated AG?
Metabolic acidosis (KLUE)
Ketoacidosis
Lactic acidosis
Uremia
Ethylene glycol or other toxins/drugs
Metabolic acidosis with a normal AG?
May be due to Cl retention or HCO3 excretion
Diarrhea or renal disease
Total CO2 is a measurement of?
HCO3- and dissolved CO2
Is TCO2 an accurate measurement of HCO3?
Yes, dissolved CO2 is only a small amount
T/F: Results of blood gas should be interpreted with physical exam, lab work, etc.
True
PaCO2 is ____ related to CO2 production and _____ related to CO2 elimination
Directly; indirectly
Results of PaCO2
- Lower the PaO2
- Lower the pH
- Reflect respiratory acidosis
- Reflect respiratory compensation for metabolic alkalosis
Does PaO2 reflect O2 content?
No
Is PaO2 or PAO2 lower?
PaO2 is always lower
Reason for high A-a difference
V/Q mismatch
Right to left shunt
Diffusion impairment (not vet med)
Reasons for V/Q mismatch
Atelectasis
Lung diseases
PaO2/FiO2 ratio
Serves same purpose as A-a gradient but easier to interpret
Normal PaO2/FiO2 ratio
> 500mmHg
Hypoxemia
Insufficient oxygenation of arterial blood
SpO2
5 Causes of Hypoxemia
- Low FiO2
- Hypoventilation
- Diffusion impairment
- V/Q mismatch
- Right to left shunt
A-a PO2 has been used to distinguish what?
Lung disease from hypoventilation as a cause of hypoxemia
Under anesthesia, what is A-a PO2 difference used to diagnose?
V/Q mismatch resulting from pulmonary atelectasis
Hypoxemia with normar PaO2
Anemia or pathological Hb
Hypoxia
Insufficient oxygenation of the tissues
Causes of hypoxia
- Hypoxemia
- Insufficient tissue perfusion
- Insufficient uptake of O2 by cells