- A-a Gradient: A-a (O2) = (FiO2%/100) * (Patm - 47 mmHg) - (PaCO2/0.8) - PaO2 (all units mmHg)
- ACID-BASE DISORDER:
- Low HCO3: Metabolic Acidosis or respiratory alkalosis à ABG
- High HCO3: respiratory acidosis or metabolic alkalosis à ABG
- ACIDEMIA (pH<7.38):
- Metabolic Acidosis (HCO3- <22): Assess secondary respiratory response - Assess AG
- NAG- Check UAG
- High AG (GOLD MARRK) (glycols [ethylene and propylene], 5-oxoproline [pyro-glutamic acid], l-lactate, d-lactate, methanol, aspirin, renal failure, rhabdomyolysis, and ketoacidosis) - Check Serum Osmolality, and Assess Δ/Δ Gap
- Respiratory Acidosis (PaCO2 > 42): Assess secondary metabolic response and A-a gradient
- ALKALEMIA (pH > 7.42):
- Metabolic Alkalosis: Assess secondary respiratory response - Exogenous Alkali or Severe hypercalcemia
- Chloride Responsive (Urine Cl < 25 )
- Chloride Resistant (Urine Cl > 40), Assess Magnesium
- Respiratory Alkalosis (PaCO2 < 38): Assess secondary metabolic response and A-a gradient
- References:
N Engl J Med 2014;371:1434-45.
N Engl J Med 2014;371:1434-45.
N Engl J Med 2014;371:1434-45.
N Engl J Med 2014;371:1434-45.
Lactic Acidosis
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