Blood Gas Analysis - Revision history

Bara at 16:12, 25 January 2011

2011-01-25T16:12:21Z

Suzannah.stacey: /* pH */

2010-11-04T20:15:40Z

Suzannah.stacey at 20:08, 4 November 2010

2010-11-04T20:08:58Z

Suzannah.stacey: /* pH */

2010-11-04T20:07:25Z

Suzannah.stacey: /* pH */

2010-11-04T20:01:50Z

Suzannah.stacey: /* Acid / Base */

2010-11-04T20:01:13Z

Acid / Base

Suzannah.stacey: /* pH */

2010-11-04T20:00:08Z

Suzannah.stacey at 19:30, 4 November 2010

2010-11-04T19:30:18Z

Suzannah.stacey at 19:30, 4 November 2010

2010-11-04T19:30:04Z

Suzannah.stacey at 10:33, 8 September 2010

2010-09-08T10:33:07Z

← Older revision		Revision as of 16:12, 25 January 2011
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	[[Category:Blood Samples and Coagulation Tests]]		[[Category:Blood Samples and Coagulation Tests]]
		+	[[Category:Monitoring Anaesthesia]]

@@ Line 7: / Line 7: @@
 *Increases indicate an alkalaemia.
 *Decreases indicate an acidemia.
-It is essential that 50-100meq of acid is excreted by the kidneys every day.  This is achieved by secretion of H<sup>+</sup> in two regions of the nephron, the proximal tubule and the collecting ducts, and is essential for maintaining the acid base ratio, within the body, at the correct levels. If there is a net gain or loss of H<sup>+</sup> within the body then the kidneys will compensate for it.  The H<sup>+</sup> ions cannot be secreted as free ions, however virtually all filtered HCO<sub>3</sub><sup>-</sup> must be reabsorbed.  The result is that the H<sup>+</sup> ions bind to other filtered buffers which are not fully reabsorbed such as ammonia or phosphate.  Extracellular pH is the main physiological regulator affecting how much acid is secreted.  In pathological states circulating volume, aldosterone and plasma potassium affect it.
+In healthy animals, it is essential that 50-100meq of acid is excreted by the kidneys every day.  This is achieved by secretion of H<sup>+</sup> in two regions of the nephron, the proximal tubule and the collecting ducts, and is essential for maintaining the acid base ratio, within the body, at the correct levels. If there is a net gain or loss of H<sup>+</sup> within the body then the kidneys will compensate for it.  The H<sup>+</sup> ions cannot be secreted as free ions, however virtually all filtered HCO<sub>3</sub><sup>-</sup> must be reabsorbed.  The result is that the H<sup>+</sup> ions bind to other filtered buffers which are not fully reabsorbed such as ammonia or phosphate.  Extracellular pH is the main physiological regulator affecting how much acid is secreted.  In pathological states circulating volume, aldosterone and plasma potassium affect it.
 [[Image:buffereg1ap.jpg|right|thumb|200px|<small><center>The HPO<sub>4</sub><sup>-</sup>Buffer System</center></small>]]
 The kidneys work with the respiratory system to regulate H<sup>+</sup>.  Where as the respiratory systems quickly compensates for a problem it is left to the kidneys to actually remove the problem and restore a proper balance.  They do this by altering the plasma concentration of HCO<sub>3</sub><sup>-</sup>.  During anaesthesia, the body's short term mechanism of respiratory change to regulate acid/base balance is compromised by the effects of the anaesthetic, and must be monitored so that relevant changes can be made manually by the anaesthetist to restore the correct acid base balance.

@@ Line 16: / Line 16: @@
 =====Acidosis=====
 In a situation of increased H<sup>+</sup> levels the body is said to be in a state of acidosis and the kidneys stop excreting HCO<sub>3</sub><sup>-</sup> and the tubular cells produce more bicarbonate.  This results in more H<sup>+</sup> being buffered and the pH increases back to normal
 ==Oxygen==

@@ Line 8: / Line 8: @@
 *Decreases indicate an acidemia.
 It is essential that 50-100meq of acid is excreted by the kidneys every day.  This is achieved by secretion of H<sup>+</sup> in two regions of the nephron, the proximal tubule and the collecting ducts, and is essential for maintaining the acid base ratio, within the body, at the correct levels. If there is a net gain or loss of H<sup>+</sup> within the body then the kidneys will compensate for it.  The H<sup>+</sup> ions cannot be secreted as free ions, however virtually all filtered HCO<sub>3</sub><sup>-</sup> must be reabsorbed.  The result is that the H<sup>+</sup> ions bind to other filtered buffers which are not fully reabsorbed such as ammonia or phosphate.  Extracellular pH is the main physiological regulator affecting how much acid is secreted.  In pathological states circulating volume, aldosterone and plasma potassium affect it.
 [[Image:buffereg1ap.jpg|right|thumb|200px|<small><center>The HPO<sub>4</sub><sup>-</sup>Buffer System</center></small>]]
-[[Image:ammoniumproxitubap.jpg|right|thumb|200px|<small><center>The Role of Ammonium in the Proximal Tubule</center></small>]]
+The kidneys work with the respiratory system to regulate H<sup>+</sup>.  Where as the respiratory systems quickly compensates for a problem it is left to the kidneys to actually remove the problem and restore a proper balance.  They do this by altering the plasma concentration of HCO<sub>3</sub><sup>-</sup>.  During anaesthesia, the body's short term mechanism of respiratory change to regulate acid/base balance is compromised by the effects of the anaesthetic, and must be monitored so that relevant changes can be made manually by the anaesthetist to restore the correct acid base balance.
 =====Alkalosis=====

@@ Line 7: / Line 7: @@
 *Increases indicate an alkalaemia.
 *Decreases indicate an acidemia.
-It is essential that 50-100meq of acid is excreted by the kidneys every day.  This is achieved by secretion of H<sup>+</sup> in two regions of the nephron, the proximal tubule and the collecting ducts, and is essential for maintaining the acid base ratio, within the body, at the correct levels. If there is a net gain or loss of H<sup>+</sup> within the body then the kidneys will compensate for it.  The H<sup>+</sup> ions cannot be secreted as free ions, however virtually all filtered HCO<sub>3</sub><sup>-</sup> must be reabsorbed.  The result is that the H<sup>+</sup> ions bind to other filtered buffers which are not fully reabsorbed such as ammonia or phosphate.  Extracellular pH is th main physiological regulator affecting how much acid is secreted.  In pathological states circulating volume, aldosterone and plasma potassium affect it.
+It is essential that 50-100meq of acid is excreted by the kidneys every day.  This is achieved by secretion of H<sup>+</sup> in two regions of the nephron, the proximal tubule and the collecting ducts, and is essential for maintaining the acid base ratio, within the body, at the correct levels. If there is a net gain or loss of H<sup>+</sup> within the body then the kidneys will compensate for it.  The H<sup>+</sup> ions cannot be secreted as free ions, however virtually all filtered HCO<sub>3</sub><sup>-</sup> must be reabsorbed.  The result is that the H<sup>+</sup> ions bind to other filtered buffers which are not fully reabsorbed such as ammonia or phosphate.  Extracellular pH is the main physiological regulator affecting how much acid is secreted.  In pathological states circulating volume, aldosterone and plasma potassium affect it.
 ===The Role of the Kidneys in Acid Base===

← Older revision		Revision as of 19:30, 4 November 2010
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	*Increases indicate a metabolic alkalosis.		*Increases indicate a metabolic alkalosis.
	*Decreases indicate a metabolic acidosis.		*Decreases indicate a metabolic acidosis.
		+
		+	[[Category:Blood Samples and Coagulation Tests]]

← Older revision		Revision as of 19:30, 4 November 2010
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−	~~{{toplink~~
−	~~\|linkpage =Anaesthesia~~
−	~~\|linktext =Anaesthesia~~
−	~~\|maplink= Anaesthesia Content Map - WikiClinical~~
−	~~\|sublink1=Monitoring Anaesthesia~~
−	~~\|subtext1=Monitoring Anaesthesia~~
−	~~\|pagetype=Clinical~~
−	}}
	==Introduction==		==Introduction==
	Blood gas analysis is the gold standard for evaluating gas exchange in a patient. Analysers measure the pH, partial pressures of oxygen and carbon dioxide of the sample directly as well as calculating other parameters such as haemoglobin saturation and plasma bicarbonate. It provides details on oxygenation, ventilation and acid-base status of the patient. Samples used are usually heparinised and can be arterial or venous, but this should be considered when interpreting results.		Blood gas analysis is the gold standard for evaluating gas exchange in a patient. Analysers measure the pH, partial pressures of oxygen and carbon dioxide of the sample directly as well as calculating other parameters such as haemoglobin saturation and plasma bicarbonate. It provides details on oxygenation, ventilation and acid-base status of the patient. Samples used are usually heparinised and can be arterial or venous, but this should be considered when interpreting results.

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 {{toplink
 |linkpage =Anaesthesia
@@ Line 8: / Line 7: @@
 |pagetype=Clinical
 }}
 ==Introduction==
 Blood gas analysis is the gold standard for evaluating gas exchange in a patient. Analysers measure the pH, partial pressures of oxygen and carbon dioxide of the sample directly as well as calculating other parameters such as haemoglobin saturation and plasma bicarbonate. It provides details on oxygenation, ventilation and acid-base status of the patient. Samples used are usually heparinised and can be arterial or venous, but this should be considered when interpreting results.