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Blood Gas Interpretation Flashcards

1
Q

Oxygenation

A

Is defined through PaO2 and SaO2 or more specifically CaO2 which will also look at Hb

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2
Q

CaO2

A

CaO2 is that total content of oxygen in the body

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3
Q

CaO2 Formula

A

(1.34HbSaO2)+(0.0031*PaO2)
Where 1.34 is the saturation capacity
0.0031 is your solubility coefficient

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4
Q

DO2

A

The delivery of oxygen to the tissues

DO2=CaO2 x CO (cardiac Output)

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5
Q

Oxygenation Determined Through

A

Spontaneous Breathing: (FiO2)

Positive Pressure Ventilation: (FiO2 and Mean Airway Pressure)

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6
Q

SaO2 and PaO2

A

Oxygen Dissociation Curve

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7
Q

Ventilation

A

Separate from oxygenation
Defined by PaCO2 and pH
Determined by
Alveolar minute ventilation= (RR x VT)

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8
Q

pH Normal Range

A

7.35-7.45

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9
Q

pH Goal Range

A

7.35-7.45

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10
Q

PaCO2 Normal Range

A

35-45 mmHg

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11
Q

PaCO2 Goal Range

A

35-45 mmHg

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12
Q

PaO2 Normal Range

A

80-100 mmHg

Partial Pressure of oxygen

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13
Q

PaO2 Goal Range

A

Greater than or equal to 60 mmHg

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14
Q

HCO3 Goal Range

A

22-26

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15
Q

Bases Excess

A

+/- 2

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16
Q

SaO2 Normal Range

A

95-100%
Should be very close to SpO2 (peripheral oxygen saturation)
Oxygen saturation in hemoglobin

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17
Q

SaO2 Goal Range

A

Greater than 90

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18
Q

Normoxemia

A

PaO2 80-100 mmHg

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19
Q

Mild Hypoxemia

A

PaO2 60-79 mmHg

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20
Q

Moderate Hypoxemia

A

PaO2 40-59 mmHg

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21
Q

Severe Hypoxemia

A

PaO2 less than 40 mmHg

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22
Q

Hyperoxemia

A

Oxygen in high levels which can be toxic

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23
Q

Hydrolysis Equation

A

CO2 + H2O H2CO3 HCO3- + H+
As CO2 production increases the bicarbonate will naturally increase as well
Do not confuse this with compensation

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24
Q

PaCO2 and HCO3

A

Acute changes in PaCO2 will cause a fairly immediate For every 10 mmHg increase in PaCO2 there is a 1 mmol/L increase in HCO3
For every 10 mmHg decrease in PaCO2 there is a 2 mmol/L decrease in HCO3

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25
Acid Base Disorders
Metabolic (Non-Respirtory) | Respiratory (Ventilation)
26
Respiratory Acid Base Disorders
A normal PaCO2 will be 35-45 mmHg < 35 will cause pH to increase/alkalemia >45 will cause pH to decrease/academia If PaCO2 is abnormal and in the opposite direction of pH then it is the primary cause
27
Respiratory Acid Base Disorders
A normal HCO3 will be 22-26 mmol/L < 22 will cause pH to decrease/academia >26 will cause pH to increase/alkalemia If HCO3 is abnormal and in the same direction of pH then it is the primary cause
28
Henderson-Hasselbalch Equation
Relationship between metabolic and respiratory acid base disorder
29
For every 10 mmHg increase in PaCO2 there is a _______ increase/decrease in pH
For every 10 mmHg increase in PaCO2 there is a corresponding decrease in pH by 0.06
30
For every 10 mmHg decrease in PaCO2 there is a _______ increase/decrease in pH
For every 10 mmHg decrease in PaCO2 there is a corresponding increase in pH by 0.10
31
Base Excess
Change in the total blood buffer base above or below normal
32
Base Excess and HCO3
The total quantity of buffer anions in the blood is approximately twice that of HCO3 HCO3 accounts for only about half of the total buffering capacity of the blood, which means that BE will provide a more complete picture of blood buffering Acute changes in PaCO2 will not affect BE This is why BE is considered to be a pure measure of metabolic components of the acid base balance
33
A positive BE
Excess base or excessive loss of acid
34
Negative BE
Excessive Acid or Excessive loss of Base
35
Acidemia
< 7.35
36
Alkalemia
> 7.45
37
pH= 7.35-7.45:
Normal Fully compensated disorder Mixed disorder
38
Compensation
Compensation will occur as the body tries to maintain a normal (or closer to normal) pH The body does not over compensate
39
Compensation in Respiratory Disorders
The metabolic system compensates by either increasing or decreasing the HCO3- levels to “correct” the pH back to normal This occurs in the kidneys through the excretion/retention of bicarbonate Full compensation may take several days While this results in both HCO3- and PaCO2 levels being abnormal it brings the pH back to (or closer to) normal
40
Compensation in Metabolic Disorders
The respiratory system responds by either increasing or decreasing minute volume resulting in a decrease or increase in PaCO2 The new PaCO2 will counteracts the metabolic problem and “corrects” the pH, resulting in both PaCO2 and HCO3 being abnormal but the end result is a pH that is normal or closer to normal
41
Predicted pH
If PaCO2 = 40: Predicted pH should = Measured pH
42
Predicted pH when PaCO2 > 40
Predicted pH = 7.40 – [(PaCO2 – 40) * .006]
43
Predicted pH when PaCO2 < 40
Predicted pH = 7.40 + [(40 - PaCO2)* .01]
44
Co-Oximetry
Will should hemoglobin levels and types
45
Types of Hemoglobin
``` Normal Methemoglobin Carboxyhemoglobin Sulfhemoglobin Fetal hemoglobin ```
46
Methemoglobin
Fe+++ reduced Hb carrying capacity
47
Carboxyhemoglobin
Up to 8% in cities | Half life of 4-6 hours in room air, as low as 35min without HBOT
48
Sulfhemoglobin
Sulfur atom blocks heme (drugs)
49
Fetal hemoglobin
Curve shift left
50
Normal Hemoglobin
Fe++
51
Uncompensated (Acute) Respiratory Acidosis
PaCO2 is high, causing a low pH | HCO3 is normal
52
Partially Compensated Respiratory Acidosis
PaCO2 is high, causing a low pH (not as low as expected for a high PaCO2 HCO3 is high in an attempt to being pH back to normal range (but has not yet done this)
53
Fully Compensated (Chronic) Respiratory Acidosis
pH is within normal range | PaCO2 and HCO3 is high
54
Uncompensated (Acute) Respiratory Alkalosis
PaCO2 is low, causing a high pH | HCO3 is normal
55
Partially Compensated Respiratory Alkalosis
PaCO2 is low, causing a high pH | HCO3 is low in an attempt to being pH back to normal range (but has not yet done this)
56
Fully Compensated (Chronic) Respiratory Acidosis
pH is within normal range | PaCO2 and HCO3 is low
57
Uncompensated (Acute) Metabolic Acidosis
HCO3 is low, causing a low pH | PaCO2 is normal
58
Partially Compensated Metabolic Acidosis
HCO3 is low, causing a low pH | PaCO2 is low in an attempt to being pH back to normal range (but has not yet done this)
59
Fully Compensated (Chronic) Metabolic Acidosis
pH is within normal range | PaCO2 and HCO3 is low
60
Uncompensated (Acute) Metabolic Alkalosis
HCO3 is high, causing a high pH | PaCO2 is normal
61
Partially Compensated Metabolic Alkalosis
HCO3 is high, causing a high pH | PaCO2 is high in an attempt to being pH back to normal range (but has not yet done this)
62
Fully Compensated (Chronic) Metabolic Alkalosis
pH is within normal range | PaCO2 and HCO3 is high
63
Uncompensated (Acute) Metabolic Acidosis
HCO3 is low causing a low pH | PaCO2 is normal
64
Partially Compensated Metabolic Acidosis
HCO3 is low causing a low pH | PaCO2 is low
65
Fully Compensated (Chronic) Metabolic Acidosis
pH is within normal range | PaCO2 and HCO3 is low
66
Combined Respiratory and Metabolic Acidosis
pH is low and both PaCO2 and HCO3 are contributing to this | High PaCO2 and a low HCO3
67
Combined Respiratory and Metabolic Alkalosis
pH is high and both PaCO2 and HCO3 are contributing to this | Low PaCO2 and a high HCO3

Patient Assessment (5 decks)

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