Cardiovascular system: Blood vessels, blood flow, blood pressure.
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Transcript of Blood Gases.pptx
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Blood Gases, pH and Buffer Systems
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Blood Gases, pH and Buffer Systems
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Blood Gases, pH and Buffer Systems
1. Definitions: Acid, Base, Buffer2. Acid-Base Balance3. Assessment of Acid-Base Homeostasis
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Blood Gases, pH and Buffer Systems
1. Definitionsa. Acid – substance that can yield H+ in waterb. Base – substance that can yield OH- in water
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Blood Gases, pH and Buffer Systems
1. Definitionsc. pK – pH in which protonated and unprotonated
forms are equal E.g: Bicarbonate-carbonic acid system - 6.1
d. Buffer – combination of weak acid or weak base and its salt
e. pH – Negative log of H+ concentration Inversely proportional to H+ concentration Venous blood = 7.35 : Arteries = 7.45
H2CO3 ↔ HCO3- + H+
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Blood Gases, pH and Buffer Systems
1. Definitions: Acid, Base, Buffer2. Acid-Base Balance3. Assessment of Acid-Base Homeostasis
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Blood Gases, pH and Buffer Systems
2. Acid-Base Balancea. Maintenance of H+
b. Buffer Systems: regulation of H+
c. Regulation of Acid-Base Balance: Lungs and Kidneys
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Blood Gases, pH and Buffer Systems
2. Acid-Base Balancea. Maintenance of H+
H+ concentration: 36-44 nmol/L (pH 7.34-7.44) Excess can lead to alterations in consciousness,
tetany, coma and death Acidosis (<7.34) and Alkalosis (>7.44) Maintained by the lungs and the kidneys
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Blood Gases, pH and Buffer Systems
2. Acid-Base Balancea. Maintenance of H+
b. Buffer Systems: Acid-Base Balance
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Blood Gases, pH and Buffer Systems
2. Acid-Base Balanceb. Buffer Systems: Acid-Base Balance
1. The Bicarbonate-Carbonic Acid System Weak Acid: Carbonic acid (H2CO3 ) Conjugate Base: Bicarbonate (HCO3
-)
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Blood Gases, pH and Buffer Systems
2. Acid-Base Balanceb. Buffer Systems: Acid-Base Balance
1. The Bicarbonate-Carbonic Acid System H2CO3 dissociate into CO2 and H2O CO2 modify the ventilation rate HCO3 can be altered by the kidneys
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Blood Gases, pH and Buffer Systems
2. Acid-Base Balanceb. Buffer Systems: Acid-Base Balance
1. The Bicarbonate-Carbonic Acid System
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Blood Gases
2. Acid-Base Balanceb. Buffer Systems: Acid-Base Balance
2. Hemoglobin (Hb) Second most
Important buffer system
Found inside RBC Most effective single
system
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Blood Gases, pH and Buffer Systems
2. Acid-Base Balanceb. Buffer Systems: Acid-Base Balance
3. Plasma Protein Ampholyte contains (+) and (-) part Free Carboxyl terminal and amino groups bind H+
4. PO4 Buffer System (Monohydrogen Phosphate - Dihydrogen Phosphate) Least important in buffering capacity
NaH2PO4 Weak Acid Na2HPO4 Conjugate Base
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Blood Gases, pH and Buffer Systems
2. Acid-Base Balanceb. Buffer Systems: Acid-Base Balance
1. The Bicarbonate-Carbonic Acid System2. Hemoglobin (Hb)3. Plasma Protein4. PO4 Buffer System
(Monohydrogen Phosphate- Dihydrogen Phosphate)
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Blood Gases, pH and Buffer Systems
2. Acid-Base Balancea. Maintenance of H+
b. Buffer Systems: Acid-Base Balance
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Blood Gases, pH and Buffer Systems
1. Definitions: Acid, Base, Buffer2. Acid-Base Balance3. Assessment of Acid-Base Homeostasis
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Blood Gases, pH and Buffer Systems
3. Assessment of Acid-Base Homeostasisa. The Bicarbonate Buffering System and
Henderson –Hasselbalch Equationb. Organs in Acid-Base Balancec. Acid-Base Disorders: Acidosis and Alkalosis
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Blood Gases, pH and Buffer Systems
3. Assessment of Acid-Base Homeostasisa. The Bicarbonate Buffering System and
Henderson –Hasselbalch Equation
Reference Range at 37°CpH 7.35-7.45pCO2 (mmHg) 35-45HCO3
- (mmol/L) 22-26H2CO3 (mmol/L) = 0.0307 x PCO2
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Blood Gases, pH and Buffer Systems
3. Assessment of Acid-Base Homeostasisa. The Bicarbonate Buffering System and
Henderson –Hasselbalch Equationb. Organs in Acid-Base Balancec. Acid-Base Disorders: Acidosis and Alkalosis
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Blood Gases, pH and Buffer Systems
3. Assessment of Acid-Base Homeostasisb. Organs in Acid Base Balance
1. Lungs (Respiratory mechanism)i. H2CO3 ↔ H2O + CO2
ii. Hyperventilation ↑ CO2 release = ↓ pCO2 (↓ H2CO3 )iii. Hypoventilation ↓ CO2 release = ↑ pCO2 (↑ H2CO3 )
H2CO3 (mmol/L) = 0.0307 x PCO2
pH 7.35-7.45pCO2 (mmHg) 35-45HCO3
- (mmol/L) 22-26
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Blood Gases, pH and Buffer Systems
3. Assessment of Acid-Base Homeostasisb. Organs in Acid Base Balance
2. Kidneys (Renal mechanism)i. H2CO3 ↔ H++ HCO3
ii. Excretion of H+ (H + + NH 3 = NH 4+ / H + + HPO4
- = H2PO4-)
iii. Reabsorption of filtered HCO3 (↓ HCO3 - ↓pH) vice-versa
H2CO3 (mmol/L) = 0.0307 x PCO2
pH 7.35-7.45pCO2 (mmHg) 35-45HCO3
- (mmol/L) 22-26
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Blood Gases, pH and Buffer Systems
3. Assessment of Acid-Base Homeostasisb. Organs in Acid Base Balance
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Blood Gases, pH and Buffer Systems
3. Assessment of Acid-Base Homeostasisa. The Bicarbonate Buffering System and
Henderson –Hasselbalch Equationb. Organs in Acid-Base Balancec. Acid-Base Disorders: Acidosis and Alkalosis
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Blood Gases
3. Assessment of Acid-Base Homeostasisc. Acid-Base Disorders: Acidosis and Alkalosis
1. Respiratory Origini. Acidosisii. Alkalosis
2. Metabolic Origini. Acidosisii. Alkalosis
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Blood Gases
3. Assessment of Acid-Base Homeostasisc. Acid-Base Disorders: Acidosis and Alkalosis
1. Respiratory Origin - Alteration in H2CO3 or CO2
i. Acidosis (Excess H2CO3 or CO2) Causes:
a. Asthma, Emphysemab. Bronchopneumoniac. Depression of respiratory centerd. Hypoventilation due to drugs (E.g. Barbiturates)e. Congestive heart failuref. OPD (Obstructive pulmonary disease)
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Blood Gases
3. Assessment of Acid-Base Homeostasisc. Acid-Base Disorders: Acidosis and Alkalosis
1. Respiratory Origin - Alteration in H2CO3 or CO2
i. Acidosis (Excess H2CO3 or CO2) Compensation (Renal)
a. ↑ Na+/H+ exchangeb. ↑ NH3 productionc. ↑ resorption of HCO3
d. ↑ excretion of acid (H+)
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Blood Gases
3. Assessment of Acid-Base Homeostasisc. Acid-Base Disorders: Acidosis and Alkalosis
1. Respiratory Origini. Acidosisii. Alkalosis
2. Metabolic Origini. Acidosisii. Alkalosis
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Blood Gases
3. Assessment of Acid-Base Homeostasisc. Acid-Base Disorders: Acidosis and Alkalosis
1. Respiratory Origin - Alteration in H2CO3 or CO2
ii. Alkalosis Excessive reduction in H2CO3 or CO2
Causes:a. High feverb. Hysteria (Hyperventilation)c. Pulmonary emboli and fibrosisd. Drugs (salicylates)
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Blood Gases
3. Assessment of Acid-Base Homeostasisc. Acid-Base Disorders: Acidosis and Alkalosis
1. Respiratory Origin - Alteration in H2CO3 or CO2
ii. Alkalosis Renal Compensation
a. ↓ Na+/H+ exchangeb. ↓ NH3 productionc. ↓ resorption of HCO3
d. ↓ excretion of acid (H+)
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Blood Gases
3. Assessment of Acid-Base Homeostasisc. Acid-Base Disorders: Acidosis and Alkalosis
1. Respiratory Origini. Acidosisii. Alkalosis
2. Metabolic (Nonrespiratory) Origini. Acidosisii. Alkalosis
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Blood Gases
3. Assessment of Acid-Base Homeostasisc. Acid-Base Disorders: Acidosis and Alkalosis
2. Metabolic Origin - Alteration in HCO3
i. Acidosis (Primary Bicarbonate Deficit: <24 mmol/L) Causes:
a. Addition Acidosis (diabetic ketoacidosis)b. Subtraction acidosis (diarrhea - ↓H2O and Na)c. Renal tubular acidosis, Acid salt (NH3Cl, CaCl)d. Starvation, Lactic acidsosise. Toxins (methanol, ethanol, ethylene glycol)f. Excessive loss of electrolytes and intestinal fluids
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Blood Gases
3. Assessment of Acid-Base Homeostasisc. Acid-Base Disorders: Acidosis and Alkalosis
2. Metabolic Origin - Alteration in HCO3
i. Acidosis (Primary Bicarbonate Deficit: <24 mmol/L) Compensation (Respiratory)
a. Hyperventilation
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Blood Gases
3. Assessment of Acid-Base Homeostasisc. Acid-Base Disorders: Acidosis and Alkalosis
1. Respiratory Origini. Acidosisii. Alkalosis
2. Metabolic Origini. Acidosisii. Alkalosis
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Blood Gases
3. Assessment of Acid-Base Homeostasisc. Acid-Base Disorders: Acidosis and Alkalosis
2. Metabolic Origin - Alteration in HCO3
i. Alkalosis Bicarbonate Excess Causes:
a. Addition Alkalosis (ingestion of alkali - NaHCO3 Na Lactate, citrate or acetate
b. Subtraction alkalosis (vomiting - ↓H2O, Na and K)c. Diuretics, Excessive gastric suctioningd. Intestinal obstruction
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Blood Gases
3. Assessment of Acid-Base Homeostasisc. Acid-Base Disorders: Acidosis and Alkalosis
2. Metabolic Origin - Alteration in HCO3
i. Alkalosis Bicarbonate Excess Compensation (Respiratory)
a. Hypoventilation
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Blood Gases
3. Assessment of Acid-Base Homeostasisc. Acid-Base Disorders: Acidosis and Alkalosis
1. Respiratory Origini. Acidosisii. Alkalosis
2. Metabolic Origini. Acidosisii. Alkalosis
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Blood Gases
3. Assessment of Acid-Base Homeostasisc. Acid-Base Disorders: Acidosis and Alkalosis
H2CO3 (mmol/L) = 0.0307 x PCO2
pH 7.35-7.45pCO2 (mmHg) 35-45HCO3
- (mmol/L) 22-26
H2CO3 (mmol/L) = 0.0307 x PCO2
HCO3 (mmol/L) = Total CO2 - H2CO3
pH 7.35-7.45pCO2 (mmHg) 35-45HCO3
- (mmol/L) 22-26
1) HCO3 = 25 H2CO3 = 32
2) HCO3 = 25 pCO2 = 35
3) Total CO2 = 27 pCO2 = 31
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Blood Gases, pH and Buffer Systems
3. Assessment of Acid-Base Homeostasisa. The Bicarbonate Buffering System and
Henderson –Hasselbalch Equationb. Organs in Acid-Base Balancec. Acid-Base Disorders: Acidosis and Alkalosis
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Blood Gases, pH and Buffer Systems
1. Definitions: Acid, Base, Buffer2. Acid-Base Balance3. Assessment of Acid-Base Homeostasis
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End of Part I