- Visit our website for more lectures: https://clinicalclub-pharmacy.blogspot.com - Subscribe to our YouTube channel: https://www.youtube.com/channel/UCNfjQs740FWbi7ac_QaYxTg - Join our facebook group: https://www.facebook.com/groups/545621324231019 - Like our facebook page: https://www.facebook.com/profile.php?id=100086195237599 - Follow us on twitter: Clinical Club (@ClinicalClubCE) / Twitter

1. ABG
In Brief
Part 1

2. Clinical Club
Clinical Club
Clinical Club ClinicalClubCE
https://clinicalclub-
pharmacy.blogspot.com

3. Alexandria Hepatology, Gastroenterology and
Fever Hospital
ZamZam Hospital
Dr/Gawad Nephrology Clinic
Msc. Clinical Pharmacy
DINAZAKIMOHAMED
ZAKI
Presented by

4. What is acid?
Acids are H+ donors.
HCL H+ + Cl
(Acid) (Hydrogen ion)(Conjugate base)
What is base?
Bases are H+ acceptors
NH3 + H NH4+
(Base) (Conjugate acid)

5. BloodPH
BloodandExtracellularFluidhasa
PHof(7.35-7.45)
Bloodis 1)Acidic 2)Basic

6. Physiologicalsourcesofacidsinblood
(CO2, CHO, FAT metabolism,
Sulphuric acids, Metabolism of
proteins,Lacticacid)
Acidexcretion:Lung(CO2),Kidneys
(Nonvolatileacidsasammonium
andphosphate)

7. Physiologicalsourcesofbasesin
blood
HCO3fromkidneys(Productionand
reclamation)

8. NORMALARTERIALBLOOD
GASVALUE

9. AnequationtocalculatethepHofabuffersolutionwas
derivedbyLawrenceJosephHendersonin1908.Karl
AlbertHasselbalchrewrotethisformulainlogarithmic
termsin1917.
HENDERSON–HASSELBALCH
EQUATION

10. CO2=Acidosis HCO3=Alkalotic
CO2=Alkalosis HCO3=Acidosis

11. Calculate
anion gap

12. AcidBaseDisorder

13. Acidosis
Alkalosis
Metabolic acidosis
(due to in bicarbonate)
Respiratory acidosis
(due to in carbonic acid)
Metabolic alkalosis
(due to in bicarbonate)
Respiratory alkalosis
(due to in carbonic acid)

14. Acidosis if PH< 7.35
If PCO2 is elevated, the primary
disorder is respiratory acidosis.
If HCO3 is decreased, the
primary disorder is metabolic
acidosis.
Assess PH, PCO2, and
HCO3

15. Alkalosis if PH> 7.45
If PCO2 is decreased, the
primary disorder is respiratory
alkalosis.
If HCO3 is elevated, the primary
disorder is metabolic alkalosis.
Assess PH, PCO2, and
HCO3

16. METABOLICACIDOSIS
1.2 mm Hg decrease in PCO2 for each 1 mmol/l fall in HCO3
Expected Compensation
PCO2=1.2* HCO3

17. METABOLICACIDOSIS
Expected Compensation
PCO2=15 + HCO3

18. METABOLICACIDOSIS
Expected Compensation
PCO2=Last 2 digits of PH

20. Calculatetheaniongap(AG)
140 meq/l
12 meq/l
24 meq/l
104 meq/l

21. Calculatetheaniongap(AG)
140 meq/l
12 meq/l
24 meq/l
104 meq/l
AG= Na+ - (Cl- + HCO3-)
Corrected AG
If there is any
hypoalbuminemia
(4-serum alb)* 2.5 +
calculated AG

22. Calculatetheaniongap(AG)
140 meq/l
12 meq/l
24 meq/l
104 meq/l
Wide AG
Normo-Chloremic
acidosis

23. Calculatetheaniongap(AG)
140 meq/l
12 meq/l
24 meq/l
104 meq/l
Normal AG
Hyper-Chloremic
acidosis

24. Calculatetheaniongap(AG)
Normal AG
Hyper-Chloremic
acidosis
Wide AG
Normo-Chloremic
acidosis
Normal

25. Calculatetheaniongap(AG)
Anion Gap= Na+ - (Cl- + HCO3-)
Normal range is 6 - 12 meq/l
If AG is> 12, there is a primary metabolic acidosis regardless of PH or
HCO3
Some patients have a mixed acid-base disorder in which they have
more than one primary disorder.
NB: Hypoalbuminemia the AG by 2.5-3 meq/l for every
1 g/dl in serum albumin< 4g/dl

26. Calculatetheexcess(AG)
Excess (AG)= Total AG - Normal AG
Add excess AG to serum bicarbonate
If the sum is> a normal serum bicarbonate (example, > 30 meq/l), there
is also an AG metabolic alkalosis (this can occur in addition to other
primary disorders)
If the sum is< a normal serum bicarbonate (example, < 23 meq/l), there
is an underlying non-AG metabolic acidosis

27. Comprehensive Clinical Nephrology
ACCP critical care
REFERENCES

28. THANKYOU
FORLISTENING!
willbecontinuedinpart2