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Acidosis and Alkalosis

Acidosis and Alkalosis. The Henderson- Hasselbach Equation…. The lungs control the volume of CO 2. The kidneys control the volume of BCO 3 -. Acidosis or Alkalosis…. What is the normal pH range?. CO 2 and HCO 3 -. What is the normal range of pCO 2?. What is the normal range of HCO 3 - ?.

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Acidosis and Alkalosis

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  1. Acidosis and Alkalosis

  2. The Henderson-Hasselbach Equation….. The lungs control the volume of CO2 The kidneys control the volume of BCO3-

  3. Acidosis or Alkalosis…. What is the normal pH range?

  4. CO2 and HCO3- What is the normal range of pCO2? What is the normal range of HCO3-?

  5. What’s going on here? pH 7.2 pCO2 9.3 kPa HCO3- 28mmol/L pO2 7.9kPa Normal Ranges pH 7.35 – 7.45 pCO2 4.5 – 6.1 HCO3- 22-28 Look at the pH, is this acidosis or alkalosis? Look at the pCO2 , is it high or low? Look at the HCO3- is it high or low? Respiratory acidosis

  6. Asthma Attack Metabolic or respiratory? Acidosis or alkalosis? Compensation mechanism? Respiratory Acidosis – constriction of airways None – asthma attack is acute so compensation mechanisms are too slow

  7. DKA Metabolic or respiratory? Acidosis or alkalosis? Compensation mechanism? Metabolic Acidosis - ketones Hyperventilation to lower CO2 (respiratory alkalosis)

  8. Vomiting Metabolic or respiratory? Acidosis or alkalosis? Compensation mechanism? Metabolic Alkalosis – loss of electrolytes Slower breathing to retain CO2 (respiratory acidosis)

  9. Panic Attack Metabolic or respiratory? Acidosis or alkalosis? Compensation mechanism? Respiratory Alkalosis – due to low CO2 None – panic attack is acute so compensation mechanisms are too slow

  10. Sepsis Metabolic or respiratory? Acidosis or alkalosis? Compensation mechanism? Metabolic Acidosis – lactic acid Hyperventilation to lower CO2 (respiratory alkalosis)

  11. Case Example A 60 year old man presented to A&E after suffering from SOB, pyrexia and a productive cough over the last 2 days. He has a history of COPD. An ABC was performed and the following values were obtained: pH: 7.2, pCO2: 9.3kPa, HCO3-: 27mmol/L, pO2: 7.9kPa pH = 7.35 – 7.35 pCO2 = 4.5-6.1 HCO3- = 22-28 Respiratoryacidosis

  12. Case Example An 80 year old man presents with a 2 day history of persistent vomiting. He is lethargic and has myalgia. He has gastroenteritis and is dehydrated. An ABC was performed and the following values were obtained: pH: 7.5, pCO2: 6.0kPa, HCO3-: 37mmol/L, pO2: 11.3kPa pH = 7.35 – 7.35 pCO2 = 4.5-6.1 HCO3- = 22-28 Metabolicalkalosis

  13. Acidosis and Alkalosis

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