- See:
-
Metabolic Acidosis
-
Resp. Acidosis
- Metabolic Alkalosis
-
Resp. Alkalosis
- Decreased PaCO2:
- if PaCOz is less than 35 mmHg and pH more than 7.45, the patient is hyperventilated and the respiratory frequency
or IMV rate of the ventilator should be reduced;
- respiratory alkalosis results in a reduced serum potassium;
- if digitalis has been prescribed, combination of digitalis and
hypokalemia can result in arrhythmias;
- PaCO2 of < 36 mmHg & pH of < 7.36 constitute hyperventilatory response to
metabolic acidosis;
- if possible, treat underlying cause of
metabolic acidosis & remeasure arterial blood gases;
- continue steps until the PaCOz and pH are within normal limits;
- Increased PaCO2:
- if PaCO is > 44 mmHg & pH is < 7.35, condition is hypoventilation;
- increase frequency of IMV, & after 20 minutes remeasure
ABG;
- if response is minimal, incorrect tidal volume may have been selected;
- increase tidal volume by 100 mL and repeat arterial blood gases;
Base deficit stratifies mortality and determines therapy.
Original Article: Assessing Acid-Base Status In Circulatory Failure: Differences between Arterial and Central Venous Blood.
