ABG 简明血气分析.ppt

1、a，1，15abg interpretation血气分析解释，simc ICU Liu，a，2，objectives，whatstman abg？understanding acid/base relationship general approach to abg interpretation clinical causes abnormal abgs case studies，a，3，侵入检查caution must be taken with patient on antiic oagulant。凝血功能障碍患者小心使用helps differentiate oxygen deficie

2、ncies fro M primary ventilator y deficiencies from primary metabolic acid-base abnormalies缺氧/通气，ph p CO2 partial pressure CO2 PO2 partial pressure O2 HCO 3 bicar bonate be base excess Sao 2 oxygen saturation，a，5，acid/base ressurea、6、case study No.1、60 y/o male comes er c/o sob。tachypneic，tachycardic

3、，Diaphoretic and cyanotic . dx acute resp . failure and a bgs show PaCO 2 well below nl，ph above nl，pao 2 is vsthe blood gas document resp。failure due to primary O2 problem。60岁的男性进入了急诊室。见呼吸亢进、心动过速、出汗、发蓝、急性呼吸衰竭的诊断。动脉血气分析结果显示，PH值略有下降，PH值升高，PH值2很低。结果主要问题是缺氧，a，7，case study No.2，60 y/o male comes er c/o

4、sob。tachypneic，tachycardic，Diaphoretic and cyanotic . dx acute resp . failure and a bgs show PaCO 2 very high，Low ph and pao 2 is moderatelythe blood gas document resp。failure due to primarly ventilator insufficiency。一名60岁男子进入急诊室。体检，呼吸塑料，心跳，出汗，发绀，急性呼吸衰竭诊断。动脉血气分析结果显示，PaCO 2很高，PH减少，pao 2减少到一般程度。结果表明，主

5、要问题是通风不足。、A、8、Buffers、There are two Buffers that work in pairs H2 co 3 nah co 3 carbonic acid base bicar bonate these Buffers are linked to the reenked function of the kidneys base bicarbonate nah co 3 process of kidneys exreting h into the urine and re absorbing HCO 3-into the blood from the renal

6、the 肾小管重吸收HCO 3-1)活性外显子Na for H between the tubular cells and glomerular filtrate在肾小管和肾小球中自发交换H 2到Na ph 7.35 7.45 p CO2 35 45 mmhg po 280 100 mmhg HCO 3 22 26 mmol/l be-2-2 Sao 2 95%，A，13，Acidosis酸中毒Alkalosis碱中毒，ph 45 HCO Emphysema肺气肿drug overdose药物过量narcosis麻醉respiratory arrest呼吸停止airway obstructio

7、n气道阻塞，a，16，代谢性气道阻塞，Failure of kidosis h2co 3 insufficiency=ph 7.45 p CO2 35，a，19，Causes of respiratory alkalsosis，hyperventilation是panic d/o pain pregnation po2l=80 100 mmhg phnl=7.35 7.45 acid otic 7.45 p CO2 NL=35 45 mmhg acid otic 45 alkalmotic 26，a，23，four-step 15abg interpretation step : study

8、PaCO2 HCO 3 respiratory irregulaty if PaCO 2 abnl HCO 3 nl呼吸机或更高版本显示PaCO 2异常。 HCO3正常metabolic irregulatory if HCO3 abnl PaCO2 nl代斯系统或更高版本HCO 3或更高版本，PaCO 2正常，a，26，four-step abg interpretion，Step 4: determine例如：主要是呼吸性酸中毒，PaCO 2会升高，ph会降低。肾脏中仍有足够的HCO3时补偿，a，27，PaCO 2 ph relationship，807 . 20607 . 30407 .

9、 40307 . 502007 . 60，a，28，15abg interpretation， normal、compensated、metabolic、alkalsosis、CO2 change、Opposes、abnormalality、alk alsososis ，respiratory acidosis metabolic alka卡尔osis respiratory alk alsosis metabolic acidosis in respiratory conditions，therefore，The kiditoryin chronic respiratory acidosis(COPD)The kidneys increase The elimination of h and absorb more HCO 3 .th