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Acidosis And Alkalosis Ppt

Surgical Procedures/acid Base Disorder

Surgical Procedures/acid Base Disorder

(Usually in clinical practice, H+ concentration is expressed as pH.) PaCO2 (Arterial CO2 concentration normal = 3545 mm Hg). HCO3 (Serum electrolytes normal = 2231 mmol/liter). Acidosis is a process that causes the accumulation of acid. Alkalosis is a process that causes the accumulation of alkali. The most common causes in the surgical practice include: Diuretic therapy (e.g., contraction alkalosis). Acid loss through GI secretions (e.g., nasogastric suctioning, vomiting). Exogenous administration of HCO3 or HCO3 precursors (e.g., citrate in blood). Chloride-unresponsive metabolic alkalosis is comparatively less common and includes: Renal tubular Cl wasting (Bartters syndrome) Measurement of urinary chloride concentration. Suggestive causes of the metabolic alkalosis if Urine Cl concentration is <15 mmol/liter: Sughgestive causes of the metabolic alkalosis if Urine Cl concentration is > 20 mmol/liter: Treatment principles in metabolic alkalosis:[ edit ] Removing and identifying underlying causes, Discontinuing exogenous alkali, repairing Cl, K+, and volume deficits. Correction of volume deficits (can be used 0.9% NaCl) and hypokalemia. H2-receptor antagonists or other acid-suppressing medications can be used after vomiting or nasogastric suctioning. Acetazolamide (5 mg/kg/day IV or PO) can be used. Eases fluid mobilization while decreasing renal HCO3 reabsorption. Tolerance to this diuretic may develop after 23 days. Ammonium chloride (NH4Cl) can be used in severe alkalemia (HCO3 >40 mmol/liter; rate not exceeding 5 ml/minute). Approximately one-half of the calculated volume of NH4Cl is usually administered and the acid-base status and Cl concentration is usually rechecked to determine the need of further treatment. Hepatic failure is contraindication for NH4Cl. HCl m Continue reading >>

Blood Gas Analysis--insight Into The Acid-base Status Of The Patient

Blood Gas Analysis--insight Into The Acid-base Status Of The Patient

Acid-Base Physiology Buffers H+ A- HCO3- CO2 Buffers H+ A- CO2 Cells Blood Kidney Lungs Fluids, Electrolytes, and Acid-Base Status in Critical Illness Blood Gas Analysis--Insight into the Acid-Base status of the Patient The blood gas consists of pH-negative log of the Hydrogen ion concentration: -log[H+]. (also, pH=pK+log [HCO3]/ 0.03 x pCO2). The pH is always a product of two components, respiratory and metabolic, and the metabolic component is judged, calculated, or computed by allowing for the effect of the pCO2, ie, any change in the pH unexplained by the pCO2 indicates a metabolic abnormality. CO +H 0ºº H CO ººHCO + H2 2 2 3 3 - + CO2 and water form carbonic acid or H2CO3, which is in equilibrium with bicarbonate (HCO3-)and hydrogen ions (H+). A change in the concentration of the reactants on either side of the equation affects the subsequent direction of the reaction. For example, an increase in CO2 will result in increased carbonic acid formation (H2CO3) which leads to an increase in both HCO3- and H+ (\pH). Normally, at pH 7.4, a ratio of one part carbonic acid to twenty parts bicarbonate is present in the extracellular fluid [HCO3-/H2CO3]=20. A change in the ratio will affect the pH of the fluid. If both components change (ie, with chronic compensation), the pH may be normal, but the other components will not. pCO -partial pressure of carbon dioxide. Hypoventilation or hyperventilation (ie, minute2 ventilation--tidal volume x respitatory rate--imperfectly matched to physiologic demands) will lead to elevation or depression, respectively, in the pCO2. V/Q (ventilation/perfusion) mismatch does not usually lead to abnormalities in PCO2 because of the linear nature of the CO2 elimination curve (ie, good lung units can make up for bad lung units). Diffus Continue reading >>

Abg Interpretation Ppt

Abg Interpretation Ppt

what is pH and what are normal values within the body a figure expressing the acidity or alkalinity of a solution on a logarithmic scale on which 7 is neutral, lower values are more acid, and higher values more alkaline. The pH is equal to -log10 c, where c is the hydrogen ion concentration in moles per liter. 7.35 to 7.45 what ranges of pH are considered abnormal what is PaO2 and what are normal values within the body Arterial partial pressure of oxygen. The higher the PaO2, the more oxygen is bound to hemoglobin and the higher the saturation (SaO2). 80 to 100 what ranges of PaO2 are considered abnormal what is PaCO2 and what are normal values within the body Arterial partial pressure of Carbon Dioxide. 35 to 45 what ranges of PaCO2 are considered abnormal what is HCO3 and what are normal values within the body A salt containing the anion HCO3-, which is the most important buffer in the blood, it is regulated by the kidney, which excretes it in excess and retains it when needed; it increases with ingestion of excessive antacids, diuretics and steroids; it is decreased with diarrhea, liver disease, renal disease and chemical poisoning. 22-28 what ranges of HCO3 are considered abnormal what are the body's acids and bases trying to do what are the body's regulatory systems for achieving acid/base homeostasis the respiratory system (O2 and CO2); and the renal system (H+ and HCO3) what is the first name in Name The Baby used to remember First name= Compensated pH= 7.35-7.45 vs Uncompensated pH= <7.35 or >7.45 what is the middle name in Name The Baby used to remember what is the last name in Name the Baby used to remember 4. ask does the HCO3 or CO2 go opposite of pH what is the pathophysiology for respiratory acidosis hypoventilation leads to increase CO2 which increases C Continue reading >>

Acid-base Disorders

Acid-base Disorders

Content currently under development Acid-base disorders are a group of conditions characterized by changes in the concentration of hydrogen ions (H+) or bicarbonate (HCO3-), which lead to changes in the arterial blood pH. These conditions can be categorized as acidoses or alkaloses and have a respiratory or metabolic origin, depending on the cause of the imbalance. Diagnosis is made by arterial blood gas (ABG) interpretation. In the setting of metabolic acidosis, calculation of the anion gap is an important resource to narrow down the possible causes and reach a precise diagnosis. Treatment is based on identifying the underlying cause. Continue reading >>

Metabolic Acidosis: Causes, Symptoms, And Treatment

Metabolic Acidosis: Causes, Symptoms, And Treatment

The Terrible Effects of Acid Acid corrosion is a well-known fact. Acid rain can peel the paint off of a car. Acidifying ocean water bleaches and destroys coral reefs. Acid can burn a giant hole through metal. It can also burn holes, called cavities, into your teeth. I think I've made my point. Acid, regardless of where it's at, is going to hurt. And when your body is full of acid, then it's going to destroy your fragile, soft, internal organs even more quickly than it can destroy your bony teeth and chunks of thick metal. What Is Metabolic Acidosis? The condition that fills your body with proportionately too much acid is known as metabolic acidosis. Metabolic acidosis refers to a physiological state characterized by an increase in the amount of acid produced or ingested by the body, the decreased renal excretion of acid, or bicarbonate loss from the body. Metabolism is a word that refers to a set of biochemical processes within your body that produce energy and sustain life. If these processes go haywire, due to disease, then they can cause an excess production of hydrogen (H+) ions. These ions are acidic, and therefore the level of acidity in your body increases, leading to acidemia, an abnormally low pH of the blood, <7.35. The pH of the blood mimics the overall physiological state in the body. In short, a metabolic process is like a power plant producing energy. If a nuclear power plant goes haywire for any reason, then we know what the consequences will be: uncontrolled and excessive nuclear energetic reactions leading to the leakage of large amounts of radioactive material out into the environment. In our body, this radioactive material is acid (or hydrogen ions). Acidemia can also occur if the kidneys are sick and they do not excrete enough hydrogen ions out of th Continue reading >>

Paediatric Acid-base Disorders: A Case-based Review Of Procedures And Pitfalls

Paediatric Acid-base Disorders: A Case-based Review Of Procedures And Pitfalls

Paediatric acid-base disorders: A case-based review of procedures and pitfalls J Bryan Carmody , MD and Victoria F Norwood , MD Department of Pediatrics, Division of Pediatric Nephrology, University of Virginia, Charlottesville, Virginia, USA Correspondence: Dr J Bryan Carmody, Department of Pediatrics, Division of Pediatric Neprhology, University of Virginia, PO Box 800386, Charlottesville, Virginia 22903, USA. Telephone 434-924-2096, e-mail [email protected] , [email protected] Copyright 2013 Pulsus Group Inc. All rights reserved Acid-base disorders occur frequently in paediatric patients. Despite the perception that their analysis is complex and difficult, a straightforward set of rules is sufficient to interpret even the most complex disorders provided certain pitfalls are avoided. Using a case-based approach, the present article reviews the fundamental concepts of acid-base analysis and highlights common mistakes and oversights. Specific topics include the proper identification of the primary disorder; distinguishing compensatory changes from additional primary disorders; use of the albumin-corrected anion gap to generate a differential diagnosis for patients with metabolic acidosis; screening for mixed disorders with the delta-delta formula; recognizing the limits of compensation; use of the anion gap to identify hidden acidosis; and the importance of using information from the history and physical examination to identify the specific cause of a patients acid-base disturbance. Keywords: Acid-base equilibrium, Acid-base imbalances, Acidosis, Alkolosis, Blood Les troubles de lquilibre acido-basique sont frquents chez les patients dge pdiatrique. Mme si on les croit difficiles et complexes analyser, des rgles simples suffsent pour interprter mme les Continue reading >>

Use Of The Ag/hco3 Ratio In The Diagnosis Of Mixed Acid-base Disorders

Use Of The Ag/hco3 Ratio In The Diagnosis Of Mixed Acid-base Disorders

Use of the AG/HCO3 Ratio in the Diagnosis of Mixed Acid-Base Disorders Department of Medicine, Yale University School of Medicine, New Haven, Connecticut Dr. Asghar Rastegar, 1072 LMP, P.O. Box 2080-30, New Haven, CT 06520-8039. Phone: 203-737-2078; Fax: 203-785-6954; E-mail: asghar.rastegar{at}yale.edu When a strong acid is added to plasma, one expects a quantitative relationship between excess anion gap (AG) and bicarbonate deficit (HCO3) with the AG/HCO3 ratio close to unity. If true, then this ratio could be used to diagnose mixed acid-base disorders in patients with metabolic acidosis. Although the mean ratio in selected patients is close to unity, this ratio also has a wide range, making its use in individual patients problematic. The ratio should therefore be used cautiously in making a diagnosis of mixed acid-base disorders. The anion gap (AG) is the difference between the concentration of selected positive and negative ions in the plasma. By convention, the AG is usually calculated as [Na (Cl + HCO3)], ignoring the concentration of potassium; in this commentary, HCO3 is also used synonymously for total CO2 (TCO2). Because the total concentration of anions and cations in plasma is equal, the AG reflects the difference between the concentration of unmeasured anions and cations. 1 A normal AG primarily reflects the concentration of nonbicarbonate buffers including albumin, phosphate, sulfate, and organic acids. Albumin is the main component of the normal AG with each gram per deciliter contributing 2.5 mEq/L to the gap calculation. 2 This contribution is pH dependent and increases with a rise in ambient pH. The elevated AG seen in metabolic alkalosis is due primarily to an increase in albumin concentration and a lesser extent to alkaline pH. 3 The normal range fo Continue reading >>

Acidosis/alkalosis | Allnurses

Acidosis/alkalosis | Allnurses

I'm studying for a test that is going to include a lot of acidosis and alkalosis information, and I'm trying to come up with a general idea of what patients would look like with metabolic and respiratory acidosis and alkalosis. Can you guys help? I'm sure I'm missing plenty of signs and symptoms. These are my ideas: Metabolic acidosis: S/S: Possibly breathing fast (to blow off CO2), disorientation/confusion, poor kidney function, low pH and bicarbonate in ABGs. Can be from diabetic ketoacidosis, severe diarrhea, or major exercising (in lactic acidosis). Metabolic alkalosis: S/S: vomiting, diarrhea, changes in level of consciousness, hypertension, poor kidney function. High pH and bicarbonate. Respiratory acidosis: S/S: Depressed respirations (not blowing off enough CO2), lethargy, fatigue. Can be from respiratory disease, like COPD, or narcotics. ABGs will have low pH and high CO2. Bicarbonate may increase to compensate. Put them in high Fowler's if possible to help respirations. Respiratory alkalosis: S/S: Tachypnea, often d/t hyperventilation or overuse of ventilators, as well as dizziness and light-headedness. ABGs will have high pH and low CO2. Use a paper bag or turn down the ventilator settings. Continue reading >>

Respiratory Acidosis

Respiratory Acidosis

Respiratory acidosis is an acid-base balance disturbance due to alveolar hypoventilation. Production of carbon dioxide occurs rapidly and failure of ventilation promptly increases the partial pressure of arterial carbon dioxide (PaCO2). [ 1 ] The normal reference range for PaCO2 is 35-45 mm Hg. Alveolar hypoventilation leads to an increased PaCO2 (ie, hypercapnia). The increase in PaCO2, in turn, decreases the bicarbonate (HCO3)/PaCO2 ratio, thereby decreasing the pH. Hypercapnia and respiratory acidosis ensue when impairment in ventilation occurs and the removal of carbon dioxide by the respiratory system is less than the production of carbon dioxide in the tissues. Lung diseases that cause abnormalities in alveolar gas exchange do not typically result in alveolar hypoventilation. Often these diseases stimulate ventilation and hypocapnia due to reflex receptors and hypoxia. Hypercapnia typically occurs late in the disease process with severe pulmonary disease or when respiratory muscles fatigue. (See also Pediatric Respiratory Acidosis , Metabolic Acidosis , and Pediatric Metabolic Acidosis .) Respiratory acidosis can be acute or chronic. In acute respiratory acidosis, the PaCO2 is elevated above the upper limit of the reference range (ie, >45 mm Hg) with an accompanying acidemia (ie, pH < 7.35). In chronic respiratory acidosis, the PaCO2 is elevated above the upper limit of the reference range, with a normal or near-normal pH secondary to renal compensation and an elevated serum bicarbonate levels (ie, >30 mEq/L). Acute respiratory acidosis is present when an abrupt failure of ventilation occurs. This failure in ventilation may result from depression of the central respiratory center by one or another of the following: Central nervous system disease or drug-induced r Continue reading >>

Respiratory Acidosis And Alkalosis

Respiratory Acidosis And Alkalosis

Automatically changes to Flash or non-Flash embed The presentation is successfully added In Your Favorites . This Presentation is Public Favorites: feed backs are mostly welcomed.. for further details u can feel free to contact me at [email protected] Respiratory Acidosis And Alkalosis Dr. Aalekh Raj DahalMBBS Respiratory Acidosis Defination: Respiratory acidosis is a condition in which a build-up of carbon dioxide in the blood produces a shift in the body's pH balance and causes the body's system to become more acidic. This condition is brought about by a problem either involving the lungs and respiratory system or signals from the brain that control breathing. There is primary increase in Pco2 with compensatory increase in HCO3 ; pH usually low but may be near normal. (Ventilatory failure; Respiratory failure; Acidosis respiratory) Carbon dioxide is produced constantly as the body burns energy, and this CO2 will accumulate rapidly if the lungs do not adequately dispel it through alveolar ventilation. Alveolar hypoventilation thus leads to an increased PaCO2 (called hypercapnia). The increase in PaCO2 in turn decreases the HCO3/PaCO2 ratio and decreases pH resulting respiratory acidosis. Etiology: HypoventilationDiseases of the airways (such as asthma and chronic obstructive lung disease), which send air into and out of the lungsDiseases of the chest (such as scoliosis), which make the lungs less efficient at filling and emptyingDiseases affecting the nerves and muscles that "signal" the lungs to inflate or deflateDrugs that suppress breathing (including powerful pain medicines, such as narcotics, and "downers," such as benzodiazepines), especially when combined with alcoholSevere obesity, which restricts how much the lungs can expand Signs and symptoms: Symptoms an Continue reading >>

Chapter 47. Acidosis And Alkalosis

Chapter 47. Acidosis And Alkalosis

DuBose TD, Jr.. DuBose T.D., Jr. DuBose, Thomas D., Jr.Chapter 47. Acidosis and Alkalosis. In: Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson J, Loscalzo J. Longo D.L., Fauci A.S., Kasper D.L., Hauser S.L., Jameson J, Loscalzo J Eds. Dan L. Longo, et al.eds. Harrison's Principles of Internal Medicine, 18e New York, NY: McGraw-Hill; 2012. Accessed April 22, 2018. DuBose TD, Jr.. DuBose T.D., Jr. DuBose, Thomas D., Jr.. "Chapter 47. Acidosis and Alkalosis." Harrison's Principles of Internal Medicine, 18e Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson J, Loscalzo J. Longo D.L., Fauci A.S., Kasper D.L., Hauser S.L., Jameson J, Loscalzo J Eds. Dan L. Longo, et al. New York, NY: McGraw-Hill, 2012, Systemic arterial pH is maintained between 7.35 and 7.45 by extracellular and intracellular chemical buffering together with respiratory and renal regulatory mechanisms. The control of arterial CO2 tension (Paco2) by the central nervous system (CNS) and respiratory systems and the control of the plasma bicarbonate by the kidneys stabilize the arterial pH by excretion or retention of acid or alkali. The metabolic and respiratory components that regulate systemic pH are described by the Henderson-Hasselbalch equation: Under most circumstances, CO2 production and excretion are matched, and the usual steady-state Paco2 is maintained at 40 mmHg. Underexcretion of CO2 produces hypercapnia, and overexcretion causes hypocapnia. Nevertheless, production and excretion are again matched at a new steady-state Paco2. Therefore, the Paco2 is regulated primarily by neural respiratory factors and is not subject to regulation by the rate of CO2 production. Hypercapnia is usually the result of hypoventilation rather than of increased CO2 production. Increases or decreases in Paco2 represent de Continue reading >>

Metabolic Acidosis & Metabolic Alkalosis

Metabolic Acidosis & Metabolic Alkalosis

Published by Lambert Morgan Modified over 2 years ago Presentation on theme: "Metabolic acidosis & Metabolic alkalosis" Presentation transcript: 1 Metabolic acidosis & Metabolic alkalosis 3 Primary Change Secondary change Net effect Hco3 Pco2 pH ( H+) Pco2 should by 1.2 mmHg for each mEq plasma Hco3 Inability to excrete dietary acid load Renal failure Renal tubular acidosis type 1 &4 Increased H+ load Lactic acidosis Ketoacidosis Toxin ingestions Increased HCO3 loss diarrhoea 5 Normal anion gap or hyper chloremic acidosis AG = Na+ (Hco3 + Cl ) Normal = 12 4 ( 8 16 ) Measure of unmeasured anion (protiens) Normal anion gap or hyper chloremic acidosis High anion gap 6 Metabolic acidosis Lactic acidosis Ketoacidosis Diarrhoea High anion gap Normal anion gap Lactic acidosis Ketoacidosis Renal failure Toxin ingestions Salicylate Methanol Ethylene glycol Diarrhoea Renal tubular acidosis 7 Clinical features Kussmals respiration (increased depth than rate) Neurologic symptoms: lethargy to coma In severe acidosis (pH< 7.1): Cardiac arrhythmia Reduced cardiac contractility Decreased inotropic response to catecholamines. Chronic acidosis Impaired growth in children Osteomalacia/osteopenia 8 Treatment Treat the underlying cause NaHCO3 therapy: Severe metabolic acidosis (pH<7.1) Chronic acidosis (sodium or potassium citrate) To alkalanise urine in salicylate poisoning 9 NaHCO3 therapy in severe acidosis: pH <7.1 Always treat the pH and not the HCO3 Only one half of bicarbonate deficit to be corrected in initial 12 hrs NaHCO3 dose= desired HCO3 observed HCO3 * 50%of body wt desired HCO3 =12 meq/L in HAG acidosis and meq/L in NAG 10 Example A 24 yr old type 1 diabetic male, weighing aroud 50 Kg presenting with fever, tachypnoea and abd pain to the EMU pH HCO pCo Urine ketones + BP 100 Continue reading >>

Difference Between Acidosis And Alkalosis

Difference Between Acidosis And Alkalosis

Home Science Chemistry Biochemistry Difference Between Acidosis and Alkalosis Difference Between Acidosis and Alkalosis The terms acidosis and alkalosis describe the abnormal condition of blood having either a higher or a lower pH than the required value. These conditions may occur due to several reasons, but most often this is caused by a disease. Acidosis indicates a lower pH than the normal pH of the blood. Alkalosis is the opposite of acidosis. It indicates a higher pH in the blood than the normal pH. The main difference between acidosis and alkalosis is that acidosis is the condition of having a lower pH than 7.35 in the blood whereas alkalosis is the condition of having a higher pH than 7.45 in blood. Key Terms: Acidosis, Alkalosis, Metabolic Acidosis, Metabolic Alkalosis, Respiratory Acidosis, Respiratory Alkalosis Acidosis is the condition of having a lower pH than the usual value in blood. If a persons blood has a pH value lower than 7.35, that person has academia, the disease caused by acidosis. Acidosis indicates a lower pH and an increased acidic nature in blood. In mammals, the normal blood pH range is given as 7.35 7.50. The build-up of acids in the blood causes the blood pH to be shifted into a lower level. The addition of acids into the bloodstream may occur in two major ways: from the digestive system and from the respiratory system. Acidosis that occurs due to the influences from digestive system is called metabolic acidosis. This is a result of consumption of highly acidic food and beverages. Excessive production of acids or reduced filtration of acids through kidneys results in acidosis. Acidosis that occurs due to the influences from respiratory system is called respiratory acidosis. The malfunctioning of the respiratory system causes respiratory a Continue reading >>

Respiratory Acidosis-alkalosis

Respiratory Acidosis-alkalosis

To view this video please enable JavaScript, and consider upgrading to a web browser that supports HTML5 video Published by Claud Lamb Modified over 2 years ago -Respiratory acidosis occurs when the lungs cant remove enough carbon dioxide (CO2). Excess CO2 makes the blood more acidic. This is because the body must balance the ions that control pH.- Normal PH: Normal Pco2 : mm Hg Normal Hco3: 22 24 mEq/L 7 Causes :- Causes of respiratory acidosis include: Diseases of the airways (such as asthma and chronic obstructive lung disease.PE. pneumonia) Diseases of the chest (such as scoliosis) Diseases affecting the nerves and muscles that "signal" the lungs to inflate or deflate(multiple sclerosis.kyphoscoliosis.MG) Drugs that suppress breathing (including powerful pain medicines, such as narcotics, and "downers," such as benzodiazepines), especially when combined with alcohol Hypoventilation 8 Clinical features Initial signs of acute respiratory acidosis include: headache anxiety blurred vision restlessness Without treatment, other symptoms may occur. These include: sleepiness tremors delirium 9 Diagnosis :- Several tools can help doctors diagnose respiratory acidosis. Blood Gas Measurement (ABC) This test measures oxygen and CO2 in the blood. High levels of CO2 can indicate acidosis. Lung Function Tests Many people with this condition have reduced lung function .especially airflow obstruction Chest X-Ray X-rays can help doctors see injuries or other problems likely to cause acidosis like pneumothorax and pneumonia Respiratory alkalosis occurs when carbon dioxide levels drop too low. This causes the pH of the blood to rise and become too alkaline Hco3 Pco2 PH 13 2.2 in Hco3 for each 10 inPco2 ((Acute)) Pco2 Alkalosis 14 Causes :- Hyperventilation Anxiety Early asthma Sepsis Continue reading >>

Effects Of Respiratory Alkalosis And Acidosis On Myocardial Blood Flow And Metabolism In Patients With Coronary Artery Disease | Anesthesiology | Asa Publications

Effects Of Respiratory Alkalosis And Acidosis On Myocardial Blood Flow And Metabolism In Patients With Coronary Artery Disease | Anesthesiology | Asa Publications

Effects of Respiratory Alkalosis and Acidosis on Myocardial Blood Flow and Metabolism in Patients with Coronary Artery Disease (Weyland, Rieke) Associate Professor of Anesthesiology. (Stephan, Sonntag) Professor of Anesthesiology. Effects of Respiratory Alkalosis and Acidosis on Myocardial Blood Flow and Metabolism in Patients with Coronary Artery Disease Anesthesiology 10 1998, Vol.89, 831-837. doi: Anesthesiology 10 1998, Vol.89, 831-837. doi: Stephan Kazmaier, Andreas Weyland, Wolfgang Buhre, Heidrun Stephan, Horst Rieke, Klaus Filoda, Hans Sonntag; Effects of Respiratory Alkalosis and Acidosis on Myocardial Blood Flow and Metabolism in Patients with Coronary Artery Disease . Anesthesiology 1998;89(4):831-837. 2018 American Society of Anesthesiologists Effects of Respiratory Alkalosis and Acidosis on Myocardial Blood Flow and Metabolism in Patients with Coronary Artery Disease You will receive an email whenever this article is corrected, updated, or cited in the literature. You can manage this and all other alerts in My Account ALTHOUGH unintended or deliberate variation of the arterial carbon dioxide partial pressure (PaCO2) is common in anesthetic practice, little is known about the myocardial consequences of respiratory alkalosis and acidosis in humans. Previous experimental studies have shown inconsistent results with respect to the effects of PaCO2on myocardial blood flow (MBF), myocardial metabolism, and global hemodynamics. This may have been caused in part by differences in the experimental design of the investigations. [1-6] Although most studies have shown that hypercapnia augments MBF above metabolic demands, [3,7-9] the results with respect to the effects of hypocapnia vary. [3,4] Furthermore, it seems questionable to transfer conclusions from experiment Continue reading >>

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