Acid Base Disturbances
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27.6.06
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–Critical care requires a good understanding
–Helps in the differential and final diagnosis
–Helps in determining treatment plan
–Treating acid/base disorders helps medications work better (i.e. antibiotics, vasopressors, etc.) –Helps in ventilator management
–Severe acid/base disorders may need dialysis
–Changes in electrolyte levels in acidosis (increased K+ and Na+, and decreases in HCO3)
The Anion Gap
- Na – (Cl + HCO3)
- NaHCO3 + HCL --> NaCL + H2CO3
- NaHCO3 + HX --> NaX+ H2CO3
- Unmeasured cations: calcium, magnesium, gamma globulins, potassium.
- Unmeasured anions: albumin, phosphate, sulfate, lactate.
- Methanol
- Uremia
- Diabetic ketoacidosis
- Paraldehyde
- INH
- Lactic acidosis
- Ethylene
- Glycol
- Salicylate
- H: hyperalimentation
- A: acetazolamide
- R: RTA
- D: diarrhea
- U: rectosigmoidostomy
- P: pancreatic fistula
Tags: Acidosis, Gap Acidosis, Anion Gap
Category: Biochemistry Notes
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