Flashcards
Metabolic Indices
Cards in this deck (24)
- 1What are the rough guidelines for the hydrolysis effect?Hypercarbia
HCO3- increase 1mEq/L for every 10 mmHg PCO2 increase
Hypocarbia
HCO3- decrease 1mEq/L for every 5 mmHg PCO2 decrease - 2What can we expect with acute C02 change?Anticipate an elevated bicarbonate 2ndary to Hydrolysis with an acute change in CO2
- 3What are 4 metabolic indicesPlasma Bicarbonate
Total CO2
Standard Bicarbonate
Base Excess - 4Plasma Bicarbonate is also called(Actual Bicarbonate or HCO3-A)
- 5How is actual bicarbonate calcuated?calculated value from pH (Sanz) & PaCO2
( Severinghaus) electrode from ABG via Henderson hasselback equation - 6Why is actual bicarbonate not totally an indicator?Influenced by respiratory disorders due to hydrolysis reaction
- 7What indice is a reflection of bicarbonate?Total C02
- 8What is Total C02 compartmentalized of? What can we use it to compare to?total CO2 = dissolved CO2 + bicarbonate
Older index of metabolic acid base status
Value can be compared to the ABG HCO3 - 9How may they get Total C02 values in a lab?Total CO2 may be done in a lab using venous blood which can have different HCO3- values
- 10What is the dissolved C02 equation?(0.03xPaC02)
- 11How much C02 in: 1.) Dissolved in Plasma 2.) Carbonic Acid in Plasma 3.) Carbaminohemoglobin in RBC 4.) Bicarbonate in Plasma 5.) Carbamino Compound in Plasma1.) 8%
2.) 0.006%
3.) 10%
4.) 80%
5.) 2% - 12How to calculate TC02TCO2= Bicarb + dissolved CO2
- 13normal ratio of bicarbonate to carbonic acid at physiologic pH is around20:1
- 14How much Total CO2 greater then serum bicarbonate?5%
- 15What occurs to patient when you observe a difference between total CO2 and bicarbonate > 5%?The patient will be acidotic
- 16Total CO2 is more so used for anion gap measurements. What is more likely used to assess acid base status?serum bicarbonate, PaCO2, and pH are used to evaluate acid-base status.
- 17What occurs in the chloride shift?
- 18What is the most accurate metabolic indicesstandard bicarbonate (HCO3-S)
- 19How do we obtain standard bicarbonate?Lab procedure – eliminate the respiratory influence on HCO3-
Actual plasma bicarb levels are calculated from pH & PCO2
converted to standard bicarb when equilibrated at 37 degrees celcius with CO2 = 40 mmHg via a tonometer
eliminate the effect PCO2 has on bicarbonate ( hydrolysis ) - 20What does standard bicarb reflect?Reflects non-respiratory or Metabolic acid/base change
- 21What is base excess/deficit?deviation of the patient’s buffer base from normal in mmol/L
base excess is also defined as the amount of acid / base that would have to be added to the patient’s blood to bring it to normal pH of 7.4 - 22How is BE calculated? What is a normal level?calculation based on measurement of pH, PaCO2 & Hb (hematocrit) – RBC has a strong influence on blood buffering
Normal = 0 +/- 2 - 23How can we compare a normal BE to observed BE?Siggard anderson nomogram
- 24For example, what does a BE of -8 mean?a base deficit of -8 would mean that 8 mEq per liter of base would have to be added to bring the patient’s blood to normal pH
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- Resp Therapy RESP 2570 - Blood Gas Flashcards on Metabolic Indices, created by Kyha Avery on 18/11/2023.
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- Kyha Avery
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