Monitoring Oxygen Balance and Acid-Base Status
13 important questions on Monitoring Oxygen Balance and Acid-Base Status
Oxyhemoglboin dissociation curve?
How can you clinically assess the determinants of cardiac output?
Preload:
right heart: Neck vein disteion, liver enlargement, depente edema, CVP
left heart, presence of dyspnoe, orthopnea, pulmonary edema, crepitations
Afterload ( leftheart ) MAP
Contractility: ejection fraction and stroke volume estimate by echocardiography
What allow an indwelling arterial catheter?
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Where is the CVC placed and what does it meassure?
It meassures central venous pressure, central venous oxygen saturation
How to determine if additional fluid is beneficial?
What is the approach for evaluation of Acid-Base disorders?
2. Check HCO3 and PaCo2
3. if a respiratory disturbance is present, determine if it is an acute or chronic
4. if a metabolic disturbance is present, determine if it is an acute or chronic
5. Always calculate the aniongap
How to estimate the AG
in severe hypoalbuminemia a decrease of AG of 2.5 a 3.0 mmol for every 1 albumin will occur.
To correct for this: AG corrected = ag observed + 2.5 ( normal - measured albumin )
Acidosis with normal AG ( often is increased )
How is metabolic alkalosis usually characterized?
chloride-expanded ( hypervolemic )
What is helpfull diagnostic tool in metabolic alkalosis?
<20 chloride depleted.
What is the limit of renal (HCO3) compensation in respiratory acidosis?
How does sepsis presents itselfs in acid-base disorders?
metabolic acidosis
The causes of elevated anios gam metabolic acidosis can be remebered with the following mnemominc: MUDPILES.
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