Documente Academic
Documente Profesional
Documente Cultură
Disorders
Wiwi J
Lab / SMF Anestesi & Reaminasi
FK Unibraw / RSU dr Saiful Anwar
Acid Base Disorders
Disorders Primary Compensatory
Charge Response
Respiratory
Acidosis PaCO2 HCO3-
Alkalosis Pa CO2 HCO3-
Metabolic
Acidosis HCO3- Pa CO2
Alkalosis HCO3- PaCO2
Etiology and Treatment of
Respiratory Acidosis
Acidosis
Physiologic Effect of Acidosis
1. Reduced Cardiac Contractility
2. Reduced Peripheral Vascular
Resistance
3. Decreased the threshold for ventricular
fibrillation
4. CNS Depression
5. Hyperkalemia
Etiology of Respiratory Acidosis
1. Alveolar Hypoventilation
1. CNS Depression
Drug Induced
Cerebral Ischemic
Cerebral Trauma
2. Chest Wall Abnormalities
Flail Chest
Kyphoscoliosis
3. Pleural Abnormalities
Pneumothorax
Pleural Effusion
Etiology of Respiratory Acidosis
1. Alveolar Hypoventilation
4. Airway Obstruction
Severe Asthma
COPD
Laryngospasme
5. Parenchymal Lung Disease
Pulmonary Edema
Pneumonia
Aspiration
Pulmonary Emboli
6. Ventilation Malfunction
Etiology of Respiratory Acidosis
Malignant Hyperthermia
Intensive Shivering
Prolonged Seizure Activity
Thyroid Storm
Extensive Thermal Injury
(burns)
Treatment of Respiratory Acidosis
1. Reverse Imbalance between CO2
production and alveolar ventilation
Increasing Alveolar Ventilation
Severe Asthma Bronchodilator
Overdose Narcotics Antidotes
ALO (mild) Diuretics
Reducing CO2 Production
Malignant Hyperthermia Dantrolen
Thyroid Storm Antithyroid
When bicarbonat is needed?
Intravenous NaHCO3 is rarely
necessary unless
pH < 7,10 and HCO3- < 15 mEq/lt