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Dr Ranjith Kumar/ ABG notes
STEP 1: PH determination
(H+) = 80
STEP 2:
ACIDOSIS
RESPIRATORY
CO2
ACUTE CHRONIC
Valid ABG =
ABG INTERPRETATION
Normal 7.35 – 7.45
(H+) = 80 – LAST 2 DIGITS OF Ph (eg:7.23)
PH
(7.34-7.45)
ACIDOSIS
CHRONIC
METABOLOC
HCO3-
ALKALOSIS
RESPIRATORY METABOLIC
[H+] [HCO3
-]
Valid ABG = ---------------------- =24
P CO2
Page 1
METABOLIC
Dr Ranjith Kumar/ ABG notes Page 2
To determine respiratory acidosis whether is acute or chronic:
ΔH
ΔPCO2
� <0.3�Chronic Respiratory acidosis
� >0.8�Acute Respiratory acidosis
� 0.3 – 0.8� Acute on Chronic � ΔH = Normal H
+ (40) subtracted by Actual patient H
+
� ΔPco2 = (Patient PCo2 – 40)
Step 3: Compensation
� Metabolic compensation for respiratory disorder
Co2 we will take as 10 in every step
Respiratory acidosis
Acute [HCO3-] increases by 1 for each 10-mm Hg increase in PCO2
Chronic [HCO3-] increases by 3.5 for each 10-mm Hg increase in PCO2
Respiratory alkalosis
Acute [HCO3-] falls by 2 for each 10-mm Hg decrease in PCO2
Chronic [HCO3-] falls by 4 for each 10-mm Hg decrease in PCO2
Acidosis Alkalosis Acidosis Alkalosis
1 2 3.5 4
ACUTE CHRONIC
Dr Ranjith Kumar/ ABG notes
� Respiratory compensation for metabolic disorder
Metabolic acidosis PCO2 = 1.5 × [HCO
Metabolic alkalosis PCO2 increases by 7 mm Hg for each 10 mEq/L increase in serum
� Mixed disorder
Corrected HCO3
compensation for metabolic disorder
= 1.5 × [HCO3-] + 8 ± 2
increases by 7 mm Hg for each 10 mEq/L increase in serum
Corrected HCO3- = Measured HCO3
- + Anion gap - 12
Met.Acidosis
Normal
Anion gap
10-12
Diarrhoea
RTA
urinary tract diversion
Ammoniam chloride intake
posthypocapnic
Positive
Anion gap
MUDPILES
Page 3
increases by 7 mm Hg for each 10 mEq/L increase in serum HCO3-
12