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if HCO3 increase, PH increases.if HCO3 decrease, PH decreases.(it goes in the same direction)
HCO3 < 22 meq/L (metabolic acidemia)HCO3 > 28 meq/L ( metabolic alkalemia)
Step 4HCO3 Metabolic element.
evaluate the problem, pure metabolic, pure respiratory or mixed.
Step 5Compansation(it goes always in the same direction as primary problem)
if pco2 increase .. Hco3 increase.if pco2 decrease .. Hco3 decrease.if Hco3 increase .. pco2 increase.if Hco3 decrease .. pco2 decrease.
Pco2 above expected range in mixed respiratory and metabloic acidosis
winter's formulaexpected paco2=1.5xHCO3+8 +/- 2
Pco2 below expected range, respiratory alkalosis (compansation)
step 6Anion Gap
Normal = 10-18 mmol/L
high anion gap metabolic acidosis> 18 mmol/L
Na + K
non anion gap metabolic acidosis(Normal)
CL + HCO3
A-a Gradient > 20 V/Q mismatch (pulmonary embolism)
A-a gradient= PAo2 (calculated in alveoli) - Pao2 (in ABG)PAo2(KPA)= (Fio2x93.8) - (Paco2x1.2)PAo2(mmhg)= (Fio2x713) - (Paco2x1.2)
Never to treat blood gases alone, you are assessing the clinical condition of the patient first and correlating it with the ABG.
correlate your finding with the patient
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