Investigation
Aliases:
Topic aliases are alternate phrasings for a particular topic.
ABG
ABGs
Arterial BG
Blood gas
Approach to the ABG
1. Clarify the FiO2 (expected pO2 ~ 5xFiO2 )
2. Acidemia or alkalemia
3. Whose fault? Respiratory (CO2) or metabolic (HCO3)
4. What is the other one doing?
a. Contributing
b. Opposing
(In met acidosis CO2 should be equal to last 2 digits of the pH eg 15mmHg with pH of 7.15)
(In respiratory acidosis the HCO3 should be 2-4mmHg per 10mmHg rise in CO2)
(In respiratory alkalosis the ?)
c. Nothing
5. Base excess (Tells you about the metabolic component of the derangement) (The amount of base that would need to be added to normalise pH when CO2 corrected to 40)
6. Anion Gap (Electrolytes)
(Na+K)-(HCO3+Cl)
Normal range 8-16
>16 =another anion present
1. Clarify the FiO2 (expected pO2 ~ 5xFiO2 )
2. Acidemia or alkalemia
3. Whose fault? Respiratory (CO2) or metabolic (HCO3)
4. What is the other one doing?
a. Contributing
b. Opposing
(In met acidosis CO2 should be equal to last 2 digits of the pH eg 15mmHg with pH of 7.15)
(In respiratory acidosis the HCO3 should be 2-4mmHg per 10mmHg rise in CO2)
(In respiratory alkalosis the ?)
c. Nothing
5. Base excess (Tells you about the metabolic component of the derangement) (The amount of base that would need to be added to normalise pH when CO2 corrected to 40)
6. Anion Gap (Electrolytes)
(Na+K)-(HCO3+Cl)
Normal range 8-16
>16 =another anion present
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Oct 26, 2012
Causes of High Anion Gap metabolic acidosis (LTKR) :
Lactate
Toxins (EtOH, ethylene glycol, mannitol)
Ketones (Acetoacetate/Betahydroxy butyrate)
Renal (urea)
#mnemonic
Lactate
Toxins (EtOH, ethylene glycol, mannitol)
Ketones (Acetoacetate/Betahydroxy butyrate)
Renal (urea)
#mnemonic
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Oct 16, 2012
Causes of normal anion gap (gain on Cl or loss of HCO3)
HARDNUP
Hyperalimentation
Acetazolamide
RTA
Diarroea
NSaline
Ureto - enteric fistula
Pancreatic fistulas
#mnemonic
HARDNUP
Hyperalimentation
Acetazolamide
RTA
Diarroea
NSaline
Ureto - enteric fistula
Pancreatic fistulas
#mnemonic
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Oct 16, 2012
Causes of normal anion gap acidosis (GRO)
GIT - Enteric HCO3- loss (Diarhoea/Gastric fistula)
Renal - RTA, HCO3- loss
Other - Hyperchloraemic metabolic-acidosis
#mnemonic
GIT - Enteric HCO3- loss (Diarhoea/Gastric fistula)
Renal - RTA, HCO3- loss
Other - Hyperchloraemic metabolic-acidosis
#mnemonic
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Oct 16, 2012