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Acid – Base Balance

Acid – Base Balance. Arterial Blood Gasses. The pH is a measurement of the acidity or alkalinity of the blood and is related to the number of H+ ions present in the blood. The more H+ present, the lower the pH will be. Likewise, the fewer H+ present, the higher the pH will be.

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Acid – Base Balance

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  1. Acid – Base Balance

  2. Arterial Blood Gasses • The pH is a measurement of the acidity or alkalinity of the blood and is related to the number of H+ ions present in the blood. • The more H+ present, the lower the pH will be. • Likewise, the fewer H+ present, the higher the pH will be. • The pH of a solution is measured on a scale from 1 (very acidic) to 14 (very alkalotic). • A liquid with a pH of 7, such as water, is neutral (neither acidic nor alkalotic).

  3. pH Scale H+ OH-

  4. Maintain the balance!!

  5. Buffering • What is a BUFFER? • A substance or group of substances that can absorb or release hydrogen ions to correct acid-base imbalance • Buffering Systems used by the body • Chemical • Biological • Physiological

  6. Chemical Buffer • Carbonic acid-bicarbonate buffer system CO2 + H20 H2CO3 H+ + HCO3- carbon water carbonic hydrogen bicarbonate dioxide acid LUNGS KIDNEY

  7. Biological Regulation • 2 Systems • First • Hydrogen ions are absorbed or released by body cells • Usually exchanged for potassium H+ K+

  8. Biological Regulation • Second System • Hemoglobin=oxyhemoglobin system CO2 Carbonic acid H+ HCO3- HgB

  9. Physiologic Regulation • Lungs • Provide a rapid adaptation to acid-base imbalance often before the biological buffer systems • Altered concentrations of hydrogen the lungs react to compensate (increased or decreased rate or depth of breath).

  10. Kidneys • Time to react ranges from a few hours to a few days. • Use three mechanisms • Reabsorb bicarbonate during acid excess and excrete it during acid deficit • Use phosphate ion (PO43-) to carry hydrogen ions by excreting phosphoric acid H3PO4 and forming an acid base. • Convert ammonia NH3 to ammonium NH4+ by attaching to a hydrogen ion

  11. Acid Base Imbalances

  12. Arterial Blood Gas (ABG) Analysis Why do we want/ need to analyze blood gasses? ABGs will tell practitioners the overall status of the patient since many of the symptoms of the acid-base imbalances are similar.

  13. Normal ABG Values

  14. Non-Mixed Acid-Base imbalances

  15. Risk Factors Therapies Diuretics Steroids IV therapy TPN GI losses Gastroenteritis Nasogastric (NG) suctioning Fistulas • Age • Very young • Very Old • Chronic Diseases • Cancer • CV disorders such as CHF • Endocrine Disorders Cushing’s Disease, DM • Malnutrition • COPD • Renal Failure • Change in LOC • Trauma • Crush • Head injury • burns

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