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RUSVM Anesthesiology > Blood Gas Analysis > Flashcards

Blood Gas Analysis Flashcards

1
Q

Acid-base homestasis =

A

maintaining normal H+

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2
Q

acid-base homestoasis involves which organs (systems)

A

lung, kidney, liver, and GI

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3
Q

chemical buffers

A

extracellular: HCO3-; acts within seconds

intracellular: phosphate, proteins; act within hours

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4
Q

respiration buffer systemm

A

adjusting CO2; acts within minutes

respiratory compensation

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5
Q

how does the renal system buffer the body

A

excreting H+, retaining HCO3-

acts within hours - powerful but slow

metabolic compensation

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6
Q

Henderson-Hasselbalch equation

A

pH≈ HCO3- / PaCO2

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7
Q

what are the measure vaiables with blood gas analysis

A

pH

PaCO2

PaO2

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8
Q

what variables are calculated with blood gas analysis

A

HCO3-

BE

oxygen content (CaO2)

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9
Q
  • emia
A

changes in blood

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10
Q

-osis

A

physiological processes

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11
Q

what variable should be assess respiratory component

A

PaCO2

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12
Q

which variable assess the metabolic component

A

BE (or HCO3-)

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13
Q

T/F there is no time for metabolic compensation during anesthesia

A

True

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14
Q

normal pH

A

7.35-7.45

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15
Q

primary acid-base disorder

A

the initial change in HCO3- or PaCO2

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16
Q

compensation

A

secondary change in HCO3- or PaCO2 in order to attenuate the effect of the primary disorder on blood pH

no classifed in the terms of acidosis/alkalosis

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17
Q

how are mixed acid-base disorders diagnosed

A

pH value is unexpected from a change in HCO3- or PaCO2

normal pH with abnormal HCO3- or PaCO2

HCO3- and PaCO2 are changing in opposite directions

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18
Q

normal HCO3-

A

24 +/- 4 mEq/L

cats tend to be lower, herbivores tend to be higher

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19
Q

normal PaCO2

A

35-45 mmHg

cats tend to be lower

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20
Q

what is base excess

A

refers to excess or deficit in the amount of base present in the blood

defines the metabolic component of acid-base dustrubances

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21
Q

what does a positive BE indicate

A

metabolic alkalosis

22
Q

what does a negative BE indicate

A

base deficit - metabolic acidosis

23
Q

what is normal BE

A

0 +/- 4 mEq/L

24
Q

TCO2 is…

A

BICARB!

25
Q

PaCO2 is

A

partial pressure (mmHg) of CO2 in the arterial blood

defines alveolar ventilation (CO2 production is normally stable)

26
Q

PaCO2 > 45

A

hypercapnia and hypoventilation

27
Q

PaCO2 < 35

A

hypocapnia and hyperventilation

28
Q

T/F any combination of RR, tidal volume, or breathing effort can reflect any PaCO2 value

A

True

29
Q

increased PaCO2 will

A

lower th PAO2 (hypoxemia) -partial pressure of O2 in alveolar space

lower the pH

refelect respiratory acidosis

reflect respiratory compensation for metabolic alkalosis

30
Q
A
31
Q

T/F PaO2 does not reflect O2 content and needs to be interpreted in light of FiO2

A

True

32
Q

what is FiO2

A

inspired O2 fraction

at 100% O2 → FiO2 = 1

at air → FiO2 = 0.21

33
Q

lower than expected PaO2 values may indicate

A

inadequate gas exchange (V/Q mismatch) resulting from pulmonary atelectasis

34
Q

if breathing 100% O2 expect PaO2…

A

>500 mmHg

35
Q

if gas exchange was perfect…

A

PAO2 = PaO2

36
Q

T/F PaO2 is always lower than PAO2

A

True

37
Q

normal values of A-a difference

A

breathing air → < 14 mmHg

breathing 100% O2 → <110 mmHg

38
Q

causes for high A-a

A

V/Q mismatch (#1 cause under anesthesia)

right to left shunt

diffusion impairment

39
Q

reasons for V/Q mismatch

A

Atelectasis (common under anesthesia)

lung disease

40
Q

when is A-a difference used

A

clinically to distinguish between lung disease (V/Q mismatch) from hypoventilation as a cause of hypoxemia

41
Q

A-a difference with hypoventillation

A

normal

42
Q

A-a difference with V/Q mismatch

A

abnormal

43
Q

PaO2 / FiO2 ratio

A

same purpose as A-a difference but easier to interpret

normal: >500 mmHg

44
Q

5 causes of hypoxemia (low PaO2)

A

low FiO2

hypoventilation

diffusion impairment

V/Q mismatch

right to left shunt

45
Q

causes of hypoxia

A

hypoxemia

insuffient tissue perfusion (e.g. low CO)

insufficient O2 uptake

46
Q

CaO2 is mostly defined by

A

[Hb] and SaO2

O2 is carried by Hb

47
Q

T/F while PaO2 is important in diagnosing V/Q mismatch, it has little impact on O2 content

A
48
Q

high lactate (>2 mmol/L) may indicate

A

increased anaerobic metabolism

49
Q

high lactate leads to

A

increased anaerobic metabolism and produced lactate and acids

symptom is called: lactic acidosis

50
Q

lactate can be used as..

A

a prognostic indicator

high lactate level that does not decrease after treament indicates poor prognosis

RUSVM Anesthesiology (39 decks)

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