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Acidemia <7.38

pH. Acidemia <7.38. Alkalemia >7.44.  pCO2.  [HCO2].  pCO2.  [HCO2]. Respiratory acidosis. Metabolic acidosis. Respiratory alkalosis. Metabolic alkalosis. Chronic or Acute? (increase) A: 1 mcq /L [HCO3]/ 10mmHg pCO2 C: 3.5 mcq /L [HCO3]/ 10mmHg pCO2. Anion Gap

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Acidemia <7.38

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  1. pH Acidemia <7.38 Alkalemia >7.44 pCO2 [HCO2] pCO2 [HCO2] Respiratory acidosis Metabolic acidosis Respiratory alkalosis Metabolic alkalosis Chronic or Acute? (increase) A: 1 mcq/L [HCO3]/ 10mmHg pCO2 C: 3.5 mcq/L [HCO3]/ 10mmHg pCO2 Anion Gap Na+ - (Cl- + HCO3-) [N=12±2] Chronic or Acute? (decrease) A: 2mcq/L [HCO3]/ 10mmHg pCO2 C: 4mcq/L [HCO3]/ 10mmHg pCO2 Increased K -> Diabetic ketoacidosis U -> Uremia S -> Salicylate intoxication S -> Starvation ketoacidosis M -> Methanol A -> Alcoholic lactic acidosis U -> Unmeasured osmoles (Ethylene glycol, paraldehyde) L -> Lactic acidosis Normal Gastrointestinal loss of HCO3- Renal tubular acidosis – types I, II, and IV Hypoaldosteronism Addition of chloride-containing acids – ammonium chloride, TPN Compensation Winter’s formula [HCO3]x1.5 + 8 ±2=pCO2 1) =  adequate compensation 2) High pCO2 Resp Acidosis 3) Low pCo2 Resp alkalosis Osmolar Gap calculated=2*Na + glu + urea OG = measured-calculated [Normal <15]

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