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Difference Between Lactic Acidosis And Ketoacidosis

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Strong Ion Difference: Etiology

Home / ABA Keyword Categories / 2015 Keywords (Defined) / Strong ion difference: Etiology Strong ions are cations and anions that exist as charged particles dissociated from their partner ions at physiologic pH. Thus, these ions are strong because their ionization state is independent of pH. The Strong Ion Difference (SID) is the difference between the positively- and negatively-charged strong ions in plasma. This method of evaluating acid-base disorders was developed to help determine the mechanism of the disorder rather than simply categorizing them into metabolic vs. respiratory acidosis/alkalosis as with the Henderson-Hasselbalch equation. Strong cations predominate in the plasma at physiologic pH leading to a net positive plasma charge of approximately +40-45. SID can be estimated as follows: SID = [strong cations] [strong anions] = [Na+ + K+ + Ca2+ + Mg2+] [Cl- + lactate-] Disturbances that increase the SID increase the blood pH (alkalosis) while disorders that decrease the SID lower the plasma pH (acidosis). According to the law of electroneutrality the sum of positive charges is equal to the sum of negative charges. Therefore the SID must be equal to the sum of weak anions Continue reading >>

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  1. meriheart

    This was from a post by JulieRN on 9/5/06. She did such a great job, I wanted it here for the record.
    Metabolic Acidosis:
    Definition
    Metabolic acidosis is a pH imbalance in which the body has accumulated too much acid and does not have enough bicarbonate to effectively neutralize the effects of the acid.
    Description
    Metabolic acidosis, as a disruption of the body's acid/base balance, can be a mild symptom brought on by a lack of insulin, a starvation diet, or a gastrointestinal disorder like vomiting and diarrhea. Metabolic acidosis can indicate a more serious problem with a major organ like the liver, heart, or kidneys. It can also be one of the first signs of drug overdose or poisoning.
    Causes and symptoms
    Metabolic acidosis occurs when the body has more acid than base in it. Chemists use the term "pH" to describe how acidic or basic a substance is. Based on a scale of 14, a pH of 7.0 is neutral. A pH below 7.0 is an acid; the lower the number, the stronger the acid. A pH above 7.0 is a base; the higher the number, the stronger the base. Blood pH is slightly basic (alkaline), with a normal range of 7.36-7.44.
    Acid is a natural by-product of the breakdown of fats and other processes in the body; however, in some conditions, the body does not have enough bicarbonate, an acid neutralizer, to balance the acids produced. This can occur when the body uses fats for energy instead of carbohydrates. Conditions where metabolic acidosis can occur include chronic alcoholism, malnutrition, and diabetic ketoacidosis. Consuming a diet low in carbohydrates and high in fats can also produce metabolic acidosis. The disorder may also be a symptom of another condition like kidney failure, liver failure, or severe diarrhea. The build up of lactic acid in the blood due to such conditions as heart failure, shock, or cancer, induces metabolic acidosis. Some poisonings and overdoses (aspirin, methanol, or ethylene glycol) also produce symptoms of metabolic acidosis.
    In mild cases of metabolic acidosis, symptoms include headache, lack of energy, and sleepiness. Breathing may become fast and shallow. Nausea, vomiting, diarrhea, dehydration, and loss of appetite are also associated with metabolic acidosis. Diabetic patients with symptoms of metabolic acidosis may also have breath that smells fruity. The patient may lose consciousness or become disoriented. Severe cases can produce coma and death.
    Diagnosis
    Metabolic acidosis is suspected based on symptoms, but is usually confirmed by laboratory tests on blood and urine samples. Blood pH below 7.35 confirms the condition. Levels of other blood components, including potassium, glucose, ketones, or lactic acid, may also be above normal ranges. The level of bicarbonate in the blood will be low, usually less than 22 mEq/L. Urine pH may fall below 4.5 in metabolic acidosis.
    Treatment
    Treatment focuses first on correcting the acid imbalance. If the patient is diabetic, insulin may be administered. Drugs to regulate blood pressure or heart rate, to prevent seizures, or to control nausea and vomiting might be given. Vital signs like pulse, respiration, blood pressure, and body temperature will be monitored. The underlying cause of the metabolic acidosis must also be diagnosed and corrected.
    OK, THAT WAS A DIRECT QUOTE OF METABOLIC ACIDOSIS, NOW LET ME TELL YOU THE DIFFERENCE BETWEEN THAT AND KETO-ACIDOSIS (DIET CAUSED).
    First let me differentiate between Metabolic Acidosis and Keto-Acidosis. BIG DIFFERENCE!!!
    Metabolic Acidosis is a life threatening state that if left untreated can cause death. Yes, Topamax had an alert on 12/18/03 by the FDA added that it "can cause decreased serum bicarbonate" as a risk (this is Metabolic Acidosis). However, this is really only to alert patients that have a predisposed medical condition that puts them at risk of metabolic acidosis already such as: Diabetics, renal disease, respiratory disorders, status epilepticus, diarrhea, vomiting, surgery, or a ketogenic diet (such as Atkins). Here is a link to define Metabolic Acidosis: www.findarticles.com/p/ar...2601000894
    If one is in Metabolic Acidosis for a long period of time undiagnosed it can result in Kidney stones, ostolysis (bone) (which might be something our members that are complaining of bone pain might want to get checked out for). Severe can cause respiratory failure or death. Metabolic Acidosis is a side effect of keto-acidosis, but by itself, in no way causes weight loss.
    Now for the Keto-Acidosis. This is a state that one goes into to cause weight loss. This is the Atkins diet theory. Low carb, high protein. It is similar (but not exact) to what happens to a diabetic when they are in Diabetic Ketosis, however we "cause" it to happen by our diet. Topamax DOES NOT CAUSE THIS. This can only be brought on by diet or starvation. Again, Metabolic Acidosis is a side effect when we are in Keto-Acidosis. We need to watch for the severe signs and symptoms while in this state. Keto-Acidosis CAUSES WEIGHT LOSS. Our body uses carbs for energy, when we don't have them our body then uses fat. The bi-product when we are (burning) using fat is Ketones in our urine. Thus - Keto-Acidosis.
    In general: Topamax does not cause one to go into Metabolic Acidosis (for the most part) but it can be a risk to some patients. Metabolic Acidosis DOES NOT cause weight loss. It can be life threatening if severe, and should be monitored for periodically by your PCP while on Topamax.
    Keto-Acidosis is the Atkins type of Acidosis that most people are familiar with. NO Topamax does not cause this either. Diet is the only thing that can bring this state on. Being in Keto-Acidosis puts you at increased risk of Metabolic Acidosis.
    I hope I was able to explain this so everyone was able to understand, if not let me know. I will try again!!!
    Julie
    >

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Acid-base Imbalance, Abnormal Blood Ph

Metabolic acidosis, metabolic alkalosis, respiratory acidosis, respiratory alkalosis, mixed acid-base disorders Derangements in blood pH result from increased intake, altered production or impaired/excessive excretion of acid or base. With time, respiratory and renal adjustments correct the pH towards normal by altering the plasma levels of pCO2 or strong ions (Na+,Cl- ), and result in predictable changes in bicarbonate concentration that can also be used to characterize the disorder (see = [(pCO2 -40)/10] +24= [(pCO2 -40)/3] +24 Acidosis: A physiologic process leading to acidemia Alkalosis: A physiologic process leading to alkalemi. Respiratory: The primary disorder results from an abnormal pCO2 --increased = acidosis; decreased = alkalosis Metabolic: The primary disorder does not result from abnormal pCO2 Mixed (Complex): More than one disorder is present Compensation: Changes in pCO2 or strong ions (Na+,Cl- ) resulting from normal physiologic mechanisms to restore acid-base balance Standard base excess (SBE): Quantity of metabolic acid-base disturbance where a positive value indicates alkalosis and a negative value (also referred to as a base deficit) indicates an acidosis Stro Continue reading >>

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  1. meriheart

    This was from a post by JulieRN on 9/5/06. She did such a great job, I wanted it here for the record.
    Metabolic Acidosis:
    Definition
    Metabolic acidosis is a pH imbalance in which the body has accumulated too much acid and does not have enough bicarbonate to effectively neutralize the effects of the acid.
    Description
    Metabolic acidosis, as a disruption of the body's acid/base balance, can be a mild symptom brought on by a lack of insulin, a starvation diet, or a gastrointestinal disorder like vomiting and diarrhea. Metabolic acidosis can indicate a more serious problem with a major organ like the liver, heart, or kidneys. It can also be one of the first signs of drug overdose or poisoning.
    Causes and symptoms
    Metabolic acidosis occurs when the body has more acid than base in it. Chemists use the term "pH" to describe how acidic or basic a substance is. Based on a scale of 14, a pH of 7.0 is neutral. A pH below 7.0 is an acid; the lower the number, the stronger the acid. A pH above 7.0 is a base; the higher the number, the stronger the base. Blood pH is slightly basic (alkaline), with a normal range of 7.36-7.44.
    Acid is a natural by-product of the breakdown of fats and other processes in the body; however, in some conditions, the body does not have enough bicarbonate, an acid neutralizer, to balance the acids produced. This can occur when the body uses fats for energy instead of carbohydrates. Conditions where metabolic acidosis can occur include chronic alcoholism, malnutrition, and diabetic ketoacidosis. Consuming a diet low in carbohydrates and high in fats can also produce metabolic acidosis. The disorder may also be a symptom of another condition like kidney failure, liver failure, or severe diarrhea. The build up of lactic acid in the blood due to such conditions as heart failure, shock, or cancer, induces metabolic acidosis. Some poisonings and overdoses (aspirin, methanol, or ethylene glycol) also produce symptoms of metabolic acidosis.
    In mild cases of metabolic acidosis, symptoms include headache, lack of energy, and sleepiness. Breathing may become fast and shallow. Nausea, vomiting, diarrhea, dehydration, and loss of appetite are also associated with metabolic acidosis. Diabetic patients with symptoms of metabolic acidosis may also have breath that smells fruity. The patient may lose consciousness or become disoriented. Severe cases can produce coma and death.
    Diagnosis
    Metabolic acidosis is suspected based on symptoms, but is usually confirmed by laboratory tests on blood and urine samples. Blood pH below 7.35 confirms the condition. Levels of other blood components, including potassium, glucose, ketones, or lactic acid, may also be above normal ranges. The level of bicarbonate in the blood will be low, usually less than 22 mEq/L. Urine pH may fall below 4.5 in metabolic acidosis.
    Treatment
    Treatment focuses first on correcting the acid imbalance. If the patient is diabetic, insulin may be administered. Drugs to regulate blood pressure or heart rate, to prevent seizures, or to control nausea and vomiting might be given. Vital signs like pulse, respiration, blood pressure, and body temperature will be monitored. The underlying cause of the metabolic acidosis must also be diagnosed and corrected.
    OK, THAT WAS A DIRECT QUOTE OF METABOLIC ACIDOSIS, NOW LET ME TELL YOU THE DIFFERENCE BETWEEN THAT AND KETO-ACIDOSIS (DIET CAUSED).
    First let me differentiate between Metabolic Acidosis and Keto-Acidosis. BIG DIFFERENCE!!!
    Metabolic Acidosis is a life threatening state that if left untreated can cause death. Yes, Topamax had an alert on 12/18/03 by the FDA added that it "can cause decreased serum bicarbonate" as a risk (this is Metabolic Acidosis). However, this is really only to alert patients that have a predisposed medical condition that puts them at risk of metabolic acidosis already such as: Diabetics, renal disease, respiratory disorders, status epilepticus, diarrhea, vomiting, surgery, or a ketogenic diet (such as Atkins). Here is a link to define Metabolic Acidosis: www.findarticles.com/p/ar...2601000894
    If one is in Metabolic Acidosis for a long period of time undiagnosed it can result in Kidney stones, ostolysis (bone) (which might be something our members that are complaining of bone pain might want to get checked out for). Severe can cause respiratory failure or death. Metabolic Acidosis is a side effect of keto-acidosis, but by itself, in no way causes weight loss.
    Now for the Keto-Acidosis. This is a state that one goes into to cause weight loss. This is the Atkins diet theory. Low carb, high protein. It is similar (but not exact) to what happens to a diabetic when they are in Diabetic Ketosis, however we "cause" it to happen by our diet. Topamax DOES NOT CAUSE THIS. This can only be brought on by diet or starvation. Again, Metabolic Acidosis is a side effect when we are in Keto-Acidosis. We need to watch for the severe signs and symptoms while in this state. Keto-Acidosis CAUSES WEIGHT LOSS. Our body uses carbs for energy, when we don't have them our body then uses fat. The bi-product when we are (burning) using fat is Ketones in our urine. Thus - Keto-Acidosis.
    In general: Topamax does not cause one to go into Metabolic Acidosis (for the most part) but it can be a risk to some patients. Metabolic Acidosis DOES NOT cause weight loss. It can be life threatening if severe, and should be monitored for periodically by your PCP while on Topamax.
    Keto-Acidosis is the Atkins type of Acidosis that most people are familiar with. NO Topamax does not cause this either. Diet is the only thing that can bring this state on. Being in Keto-Acidosis puts you at increased risk of Metabolic Acidosis.
    I hope I was able to explain this so everyone was able to understand, if not let me know. I will try again!!!
    Julie
    >

  2. -> Continue reading
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Understand medical acid base balance and problems with this clear explanation from Dr. Seheult. See the whole acid base video series free at http://www.medcram.com. This video is part of the "MedCram Remastered" series: A video we've re-edited & sped up to make learning even more efficient. This medical acid-base course includes: - The difference between acidosis, academia, alkalosis, and alkalemia - Anion gap, metabolic acidosis, metabolic alkalosis, respiratory acidosis, respiratory alkalosis, and acid-base practice problems - Acid base physiology, Arterial blood gasses (ABGs), pH, and relevant equations Visit https://www.MedCram.com for this entire course and over 100 free lectures. This is the home for all new and updated MedCram medical videos (many videos, medical lectures, and quizzes are not on YouTube). Speaker: Roger Seheult, MD Co-Founder of MedCram.com (https://www.medcram.com) Clinical and Exam Preparation Instructor Board Certified in Internal Medicine, Pulmonary Disease, Critical Care, and Sleep Medicine. MedCram: Medical education topics explained clearly including: Respiratory lectures such as Asthma and COPD. Renal lectures on Acute Renal Failure and Adrenal Gland

Acid/base Disorders Flashcards | Quizlet

You do not need to know this for the test. Apart from the carbonic acid/bicarbonate/pCO2 equilibrium, what else helps the body regulate a buffered pH? The kidneys help regulate body pH. How do they do it? Bicarbonate (HCO3-) is reabsorbed at the proximal tubule (85%). Bicarbonate is a base. Excreting bicarbonate would make the body compartment more acidic. Excretion of H+ can happen at the distal tubule. H+ has to be stuck on another molecule for it to catch a ride out of the body. It does so in the form of an ammonium cation (NH3+ H+ ---> [NH4]+), or a phosphate anion (HPO3 2- or H2PO3 1-). The lungs help regulate body pH. How does that work? Your lungs help regulate the pCO2 (carbon dioxide gas in solution) in your body. When they work faster, they get rid of the pCO2. When your lungs lower pCO2, the buffered system will pull from the H2CO3, producing H2O and CO2. Pretty much, your lungs get rid of acidic molecules. Both the lungs and the kidneys regulate body pH. Which organ system can respond faster to a change in body pH? Our body has peripheral and central chemoreceptors to sense pH. Where are they? What is the range of pH considered normal in arterial blood? What is the ran Continue reading >>

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  1. meriheart

    This was from a post by JulieRN on 9/5/06. She did such a great job, I wanted it here for the record.
    Metabolic Acidosis:
    Definition
    Metabolic acidosis is a pH imbalance in which the body has accumulated too much acid and does not have enough bicarbonate to effectively neutralize the effects of the acid.
    Description
    Metabolic acidosis, as a disruption of the body's acid/base balance, can be a mild symptom brought on by a lack of insulin, a starvation diet, or a gastrointestinal disorder like vomiting and diarrhea. Metabolic acidosis can indicate a more serious problem with a major organ like the liver, heart, or kidneys. It can also be one of the first signs of drug overdose or poisoning.
    Causes and symptoms
    Metabolic acidosis occurs when the body has more acid than base in it. Chemists use the term "pH" to describe how acidic or basic a substance is. Based on a scale of 14, a pH of 7.0 is neutral. A pH below 7.0 is an acid; the lower the number, the stronger the acid. A pH above 7.0 is a base; the higher the number, the stronger the base. Blood pH is slightly basic (alkaline), with a normal range of 7.36-7.44.
    Acid is a natural by-product of the breakdown of fats and other processes in the body; however, in some conditions, the body does not have enough bicarbonate, an acid neutralizer, to balance the acids produced. This can occur when the body uses fats for energy instead of carbohydrates. Conditions where metabolic acidosis can occur include chronic alcoholism, malnutrition, and diabetic ketoacidosis. Consuming a diet low in carbohydrates and high in fats can also produce metabolic acidosis. The disorder may also be a symptom of another condition like kidney failure, liver failure, or severe diarrhea. The build up of lactic acid in the blood due to such conditions as heart failure, shock, or cancer, induces metabolic acidosis. Some poisonings and overdoses (aspirin, methanol, or ethylene glycol) also produce symptoms of metabolic acidosis.
    In mild cases of metabolic acidosis, symptoms include headache, lack of energy, and sleepiness. Breathing may become fast and shallow. Nausea, vomiting, diarrhea, dehydration, and loss of appetite are also associated with metabolic acidosis. Diabetic patients with symptoms of metabolic acidosis may also have breath that smells fruity. The patient may lose consciousness or become disoriented. Severe cases can produce coma and death.
    Diagnosis
    Metabolic acidosis is suspected based on symptoms, but is usually confirmed by laboratory tests on blood and urine samples. Blood pH below 7.35 confirms the condition. Levels of other blood components, including potassium, glucose, ketones, or lactic acid, may also be above normal ranges. The level of bicarbonate in the blood will be low, usually less than 22 mEq/L. Urine pH may fall below 4.5 in metabolic acidosis.
    Treatment
    Treatment focuses first on correcting the acid imbalance. If the patient is diabetic, insulin may be administered. Drugs to regulate blood pressure or heart rate, to prevent seizures, or to control nausea and vomiting might be given. Vital signs like pulse, respiration, blood pressure, and body temperature will be monitored. The underlying cause of the metabolic acidosis must also be diagnosed and corrected.
    OK, THAT WAS A DIRECT QUOTE OF METABOLIC ACIDOSIS, NOW LET ME TELL YOU THE DIFFERENCE BETWEEN THAT AND KETO-ACIDOSIS (DIET CAUSED).
    First let me differentiate between Metabolic Acidosis and Keto-Acidosis. BIG DIFFERENCE!!!
    Metabolic Acidosis is a life threatening state that if left untreated can cause death. Yes, Topamax had an alert on 12/18/03 by the FDA added that it "can cause decreased serum bicarbonate" as a risk (this is Metabolic Acidosis). However, this is really only to alert patients that have a predisposed medical condition that puts them at risk of metabolic acidosis already such as: Diabetics, renal disease, respiratory disorders, status epilepticus, diarrhea, vomiting, surgery, or a ketogenic diet (such as Atkins). Here is a link to define Metabolic Acidosis: www.findarticles.com/p/ar...2601000894
    If one is in Metabolic Acidosis for a long period of time undiagnosed it can result in Kidney stones, ostolysis (bone) (which might be something our members that are complaining of bone pain might want to get checked out for). Severe can cause respiratory failure or death. Metabolic Acidosis is a side effect of keto-acidosis, but by itself, in no way causes weight loss.
    Now for the Keto-Acidosis. This is a state that one goes into to cause weight loss. This is the Atkins diet theory. Low carb, high protein. It is similar (but not exact) to what happens to a diabetic when they are in Diabetic Ketosis, however we "cause" it to happen by our diet. Topamax DOES NOT CAUSE THIS. This can only be brought on by diet or starvation. Again, Metabolic Acidosis is a side effect when we are in Keto-Acidosis. We need to watch for the severe signs and symptoms while in this state. Keto-Acidosis CAUSES WEIGHT LOSS. Our body uses carbs for energy, when we don't have them our body then uses fat. The bi-product when we are (burning) using fat is Ketones in our urine. Thus - Keto-Acidosis.
    In general: Topamax does not cause one to go into Metabolic Acidosis (for the most part) but it can be a risk to some patients. Metabolic Acidosis DOES NOT cause weight loss. It can be life threatening if severe, and should be monitored for periodically by your PCP while on Topamax.
    Keto-Acidosis is the Atkins type of Acidosis that most people are familiar with. NO Topamax does not cause this either. Diet is the only thing that can bring this state on. Being in Keto-Acidosis puts you at increased risk of Metabolic Acidosis.
    I hope I was able to explain this so everyone was able to understand, if not let me know. I will try again!!!
    Julie
    >

  2. -> Continue reading
read more

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