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Çukurova Üniversitesi Tıp Fakültesi
PaO2 209 mmHg PaCO2 11 mmHg
B.E. - 14.6 mmol/L Total CO28 mEq/L
HCO3- 7.7 mmol/L
Hb 9.5 g/dl Na+ 135 mEq/L
Cl- 95 mEq/L K+ 5.5 mEq/L
= 40 nmol/L
= - log (40x10-9 mol/L)
= - log [H+]
= 40 x 10-9 mol/L
7.0 7.2 7.4 7.6
6.9 7.1 7.3 7.5 7.7
Hemoglobin g/100 ml
SBE = 0.9287 x [HCO3- - 24.4 + (pH-7.4)]
[Çözünmüş CO2] +
[Karbamino CO2] +
Each day there is always a production of acid by the body’s metabolic processes and to maintain balance, these acids need to be excreted or metabolised. The various acids produced by the body are classified as respiratory (or volatile) acids and as metabolic (or fixed) acids. The body normally can respond very effectively to perturbations in acid or base production.
2.1.1 Respiratory Acid
The acid is more correctly carbonic acid (H2CO3) but the term 'respiratory acid' is usually used to mean carbon dioxide. But CO2 itself is not an acid in the Bronsted-Lowry system as it does not contain a hydrogen so cannot be a proton donor. However CO2 can instead be thought of as representing a potential to create an equivalent amount of carbonic acid. Carbon dioxide is the end-product of complete oxidation of carbohydrates and fatty acids. It is called a volatile acid meaning in this context it can be excreted via the lungs. Of necessity, considering the amounts involved there must be an efficient system to rapidly excrete CO2.
The amount of CO2 produced each day is huge compared to the amount of production of fixed acids. Basal CO2 production is typically quoted at 12,000 to 13,000 mmols/day.
Basal Carbon Dioxide Production Consider a resting adult with an oxygen consumption of 250 mls/min and a CO2 production of 200 mls/min (Respiratory quotient
Increased levels of activity will increase oxygen consumption and carbon dioxide production so that actual daily CO2 production is usually significantly more than the oft-quoted basal level. [Different texts quote different figures usually in the range of 12,000 to 24,000 mmoles/day but the actual figure simply depends on the level of metabolic activity and whether you quote basal or typical figures.]
Daily CO2 production can also be calculated from the daily metabolic water production. The complete oxidation of glucose produces equal amounts of CO2 and H20. The complete oxidation of fat produces approximately equal amounts of CO2 and H2O also. These two processes account for all the body’s CO2 production. Typically, this metabolic water is about 400 mls per day which is 22.2 moles (ie 400/18) of water. The daily typical CO2 production must also be about 22,200 mmoles.
H2O + CO2H2CO3 H+ + HCO3-
Ekstrasellüler sıvı kompartmanının hızlı dilüsyonu (bikarbonatsız mayi NEDEN???
= [Na+] – ([Cl-] + [HCO3-])
= 140 – (104 + 24)
= 12 meq/L (8-16 meq/L)
Tüm organik anyonlar
Venöz: 4.5 - 19.8 mg/dL - Arteryel: 4.5 - 14.4 mg/dL (0.4-1.4 mmol/L)
Morgan GE, Clinical Anesthesiology
= 378 mEq
PaO2 209 mmHg PaCO211 mmHg
B.E. - 14.6 mmol/L Total CO2 8 mEq/L
Hb 9.5 g/dl Na+135 mEq/L
Cl- 95 mEq/L K+ 5.5 mEq/L
= Na+ – Cl- – tCO2
= 135 – 95 – 8
= 32 mEq/L
= 14.4 mmol/L
PaO2 136 mmHg PaCO223 mmHg
B.E. - 3.0 mmol/L Total CO2 18.5 mEq/L
Hb 10.3 g/dl Na+137 mEq/L
Cl- 92 mEq/L K+ 3.9 mEq/L
Laktat 2.7 mmol/L
24 SAAT SONRA
PaO2 124 mmHg PaCO235 mmHg
B.E. + 5.0 mmol/L Total CO2 27 mEq/L
Hb 15 g/dl Na+136 mEq/L
Cl- 91 mEq/L K+ 3.2 mEq/L
Laktat 2.7 mmol/L
Normal kan gazı
Respiratuar alkaloz, kompanse değil
Metabolik asidoz, kısmen kompanse
Respiratuar asidoz, kompanse
Metabolik alkaloz, kompanse değil
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