AcidBase


Good information regarding base excess:

PaCO2 nl 40 mmHg:
PaCO2 nl 40 mmHg: increase 1 leads to pH decrease of 0.008
ex. PaCO2 60 = 7.24 / 80 = 7.08 / 100 = 6.92
               
Met Acidosis: PCO2 = 1.5(HCO3-) + 8 +/- 2
- IOW, as you metabolically in bicarb (met alk), PCO2 will rise to compensate.

Met Alk: HCO3-  increase 1 mEq/L leads to increase 0.7 PCO2
HCO3 = 24 PCO2 = 40.0
HCO3 = 25 PCO2 = 40.7
HCO3 = 26 PCO2 = 41.4
HCO3 = 27 PCO2 = 42.1
HCO3 = 28 PCO2 = 42.8
HCO3 = 29 PCO2 = 43.5
HCO3 = 30 PCO2 = 44.2
HCO3 = 31 PCO2 = 44.9
HCO3 = 32 PCO2 = 45.6
HCO3 = 33 PCO2 = 46.3
HCO3 = 34 PCO2 = 50
HCO3 = 35 PCO2 = 50.7
HCO3 = 36 PCO2 = 51.4
HCO3 = 37 PCO2 = 52.1

HCO3- nl 24 mEq/L: decrease 1 mEq/L leads to decrease 1 mEq PCO2
HCO3- nl 24 mEq/L: increase 10 mEq/L leads to increase .15 pH

Arterial Oxygen Concentration:
CaO2 = Hb(1.34) x SaO2 + PaO2 X .003

Metabolic acidosis:
Anion gap: MUDPILES
Normal gap: USEDCARP - uterostemy, small bowel fistula, extra chloride, diarrhea, cabonic anhydrase inhibitors (eg acetazolamide), adrenal insufficiency, rta, pancreatic fistula.
Decreased gap: hyperkalemia, hypercalcemia, hypermagnesemia, hypoalbuminemia.

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