血气分析——英文版教学教材.ppt

《血气分析——英文版教学教材.ppt》由会员上传分享，免费在线阅读，更多相关内容在教育资源-天天文库。

1、血气分析——英文版RulesofThumbforRecognizingPrimaryAcid-BaseDisordersWithoutUsingaNomogramRule1LookatthepH.Whicheversideof7.40thepHison,theprocessthatcausedittoshifttothatsideistheprimaryabnormality.Principle:Thebodydoesnotfullycompensateforprimaryacid-basedisordersSimpleAcid-BaseDisordersAcuteResp

2、iratoryAlkalosisArterialGasValueInterpretationpHPCO2*HCO37.5029mmHg22mmol/LAlkalemiaRespiratoryalkalosisNormalHCO3CausesAnxietyHypoxiaLungdiseasewithorwithouthypoxiaCentralnervoussystemdiseaseDruguse–salicylates,catecholamins,progesteronePregnancySepsisHepaticencephalopathyMechanicalventil

3、ation*ThisistheprimaryabnormalityAcuteRespiratoryAcidosisArterialGasValueInterpretationpHPCO2*HCO37.2560mmHg26mmol/LAcidemiaRespiratoryacidosisNormalHCO3CausesCentralnervoussystem(CNS)depression–drugs,CNSeventNeuromusculardisorders–myopathies,neuropathiesAcuteairwayobstruction–upperairway,

4、laryngospasm,bronchospasmSeverepneumoniaorpulmonaryedemaImpairedlungmotion–hemothorax,pneumothoraxThoraciccageinjury–flailchestVentilatordysfunction*ThisistheprimaryabnormalityChronicRespiratoryAcidosisWithMetabolicCompensationArterialGasValueInterpretationpHPCO2*HCO37.3460mmHg31mmol/LResp

5、iratoryacidosisMetaboliccompensationCausesChroniclungdisease–obstructiveorrestrictiveChronicneuromusculardisordersChronicrespiratorycenterdepression–centralhypoventilation*ThisistheprimaryabnormalityTheImportanceofDifferentiatingAcuteFromChronicRespiratoryAcidosisAcuterespiratoryacidosisMe

6、dicalemergencyrequiringemergentintubationandmechanicalventilationChronicrespiratoryacidosisOftenaclinicallystableconditionMetabolicAcidosisWithRespiratoryCompensationArterialGasValueInterpretationpHPCO2HCO3*7.5048mmHg36mmol/LAlkalemiaRespiratorycompensationMetabolicalkalosisCausesUrinaryCh

7、lorideLevelLowUrinaryChlorideLevelNormalorHighVomiting,nasogastricsuctionDiureticuseinpastPosthypercapniaExcessmineralocorticoidactivity–Cushing’ssyndrome,Conn’ssyndrome,exogenoussteroids,licoriceingestion,increasedreninstates,Bartter’ssyndromeCurrentorrecentd