asam basa

Rita Sekarsari, SKp, CVRN, MHSM

Terminology

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ACIDIC NEUTRAL ALKALOTIC

•Acid: a donator of hydrogen ions ( H+), any substance with a pH less than 7.0

•Senyawa yang dapat melepas ion hidrogen (H+) jika dilarutkan dalam air HCl H+ + Cl –

•Acid: senyawa yang dapat memberikan proton (H+) kepada senyawa lain HCl + H2O H3O+ + Cl –

•Acidemia: the condition of blood with a pH below 7.35

•Acidosis : the process, be it metabolic or respiratory, that the causes the acidemia

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•Base: an acceptor of hydrogen ions, any substance with a pH greater than 7.0

•Senyawa yang dapat melepas ion hidroksida (OH -) jika dilarutkan dalam air

•Senyawa yang dapat menerima proton (H+) dari senyawa lain

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•Alkalemia: the condition of blood with a pH above 7.45

•Alkalosis: the process, be it metabolic or respiratory, that causes the alkalemia

•pH: the negative logarithm of hydrogen ion concentration *Increase in (H+) = lower pH, more acidic *Decrease in (H+) = higher pH, more alkaline

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Buffering: to prevent changes in (H+) concentration

•Bicarbonate (HCO3 -) buffer system(H+) + HCO3 H2CO3 CO2 + H2O

•Phosphate systems

•Hemoglobin and other proteins

Kidney Lungs

Components of Arterial Blood Gas

•pH : measurement of acidity or alkalinity,based on the hydrogen (H+) ions presentThe normal range is 7.35 to 7.45

•PaO2: the partial pressure of oxygen that isdissolved in arterial bloodThe normal range is 80 to 100 mm Hg

•SaO2: The arterial oxygen saturationThe normal range is 95% to 100 %

•PaCO2: the amount of carbon dioxide dissolved in arterial blood. The normal range is 35 - 45 mmHg

•HCO3 : The calculated value of the amount of bicarbonate in the bloodstream The normal range is 22 to 26 mEq/liter

•BE: the base excess indicates the amount of excess or insufficient level of bicarbonate in system. The normal range is -2 to +2 mEq/liter

Steps to ABGs Interpretation

Compensation

RESPIRATORY ACIDOCIS

RESPIRATORY ALKALOSIS

•Psychological responses such as anxiety or fear

•Pain

•Increase metabolic demands such as fever, pregnancy or thyrotoxicosis

•Medication such as respiratory stimulant

•Central nervous system lesions

METABOLIC ACIDOSIS

•Renal failure

•Diabetic ketoacidosis

•Anaerobic metabolism

•Starvation

•Salicylate intoxication

METABOLIC ALKALOSIS

•Ingestion of antacids

•Excess use of bicarbonate

•Use of lactate in dialysis

•Excess administration of diuretics