BLOOD GASES, PH & BUFFER SYSTEMS
HASSEKBALCH EQUATION
DEFINITIONS:
 ACID
- is a substance that can yield a hydrogen ion
(H+) or hydrogen ion when dissolved in water
 BASE
- is a substance that can yield hydroxyl ions
(OH-)
 DISSOCIATION CONSTANT (K VALUE)
- Relative strengths of acids and bases – their
ability to dissociate in water
 PK
- negative Log of the ionization constant
- the ph in which the protozonated and
unpronated forms are present in equal
concentrations
 7.35 – 7.45 (Avg: 7.4)
- Normal pH of blood
- 100mL of distilled water = pH 7.35
- Add one drop of 0.05 N HCl = pH 7.35 - 7.00
- To change 100mL of normal blood from a pH
of 7.35 to a pH of 7.0, approximately 25mL of
0.05 N HCl is needed
- With 5.5L of blood, more than 1300mL of HCl
would be required to make this same
change in pH.
 BICARBONATE ION CONCENTRATION
- Bicarbonate ion concentration in the blood
that has been equiliberated with CO2 at
40mmhg at 37ºC
- 22-26mmol/L
 PARTIAL PRESSURE OF O2
- the pressure or tension exerted by oxygen
gas dissolved in arterial blood which reflects
the availability of the gas in blood but not its
content
- 80-110mmol/L
ACID BASE BALANCE
 Maintenance of H+
 Increases H+ will cause alterations in the rate
of chemical reactions within the cell and
affect the many metabolic processes of the
body
 can lead to alterations in consciousness,
neuromuscular irritability, and death.
BUFFER SYSTEM
 Regulation f H+
 Bicarbonate-carbonic acid buffer system,
consist of a weak acid (HCO3-)
 When an acid is added, HCO3- will combine
with the H+ form the H2CO3
 when a base is added, will combine with the
OH- group to form H2O and HCO3-
 there is a smaller change in pH in both cases
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BICARBONATE BUFFERING SYSTEM AND HENDERSON-
BICARBONATE BUFFERING SYSTEM
 dissolved CO2 (DCO2) is in equilibrium with
CO2 gas, which can be expelled by way of
the lungs
 open system
DCO2
 Controlled by the lungs
 Respiratory component
ACID-BASE DISORDERS
ACIDEMIA
 pH less than 7.35-7.45
 reflects excess acid or H+ concentration
ALKALEMIA
 pH greater than 7.35-7.45
 reflects excess base
PRIMARY RESPIRATORY ACIDOSIS
 caused by ventilatory dysfunction (a chance
in PCO2)
METABOLIC (NONRESPIRATORY DISORDER)
 resulting from a change in the HCO3 ion level
COMPENSATION
 for substances of the respiratory component,
the kidneys compensate by selectively
excreting or reabsorbing anions and cations
 lungs can compensate immediately, but the
response is short term and often incomplete
 kidneys are to respond (2-4 days), however,
but the response is long term and potentially
complete
ACIDOSIS
 PRIMARY NONRESPIRATORY ACIDOSIS
- Decrease in bicarbonate, resulting in a
decreased pH as a result of the ratio for
the nonrespiratory to respiratory
components less than 20:1
- COMPENSATION
- Through HYPERVENTILATION, which is an
increase in the rate or depth or breathing
- By “BLOWING OFF” CO2, the BASE -TO-
ACID ratio will return toward normal
- SECONDARY COMPENSATION occurs
when the “original” organ (kidney) begins
to correct ratio by retaining bicarbonate
 PRIMARY RESPIRATORY ACIDOSIS
- Hypoventilation caused by drugs,
mechanical, obstruction, and
asphyxiation, will increase blood PCO2
levels
- DECREASED CARDIAC OUTPUT (CHF), less
blood presented to the lungs for gas
exchange, and therefore, an elevated
PCO2
 ALKALOSIS 7. FINAL INTERPRETATION
 PRIMARY NONRESPIRARATORY ALKALOSIS a. Degree of Compensation
- Resulting from a gain in HCO3-, causing an b. Primary Disorder
increase in the nonrespiratory component c. Degree of Oxygenation
and increase in the pH
 PRIMARY RESPIRATORY ALKALOSIS
- results from an increased rate of alveolar
ventilation causing excessive elimination
of carbon dioxide by the lungs
SPECIMEN COLLECTION FOR ABG
ATRIAL BLOOD
 Heparinized Plastic Syringe
- Excess heparin causes downward shifting
of blood pH
- Leaking of gas through plastic
 Glass Syringe Pretreated with Heparin
 Heparinized Evacuated Tubes
- With oxygen contamination which
increases PO2
- Blood samples should be chilled with the
use of ICE CHIPS to prevent O2
consumption by the RBC and release of
ACIDIC METABOLITES
EVALUATION OF ABG RESULTS
PARAMETERS
 pH
 PCO2
 HCO3-
 PO2

1. EVALUATE THE PH
- pH = 7.35-7.45
- <7.35 = ACIDOSIS
- >7.45 = ALKALOSIS
2. EVALUATE THE VENTILATION (LUNGS)
- PCO2 = 35-45mmhg
- <35 = RESPIRATORY ALKALOSIS
- >45 = RESPIRATORY ACIDOSIS
3. EVALUATE THE METABOLIC PROCESS (KIDNEYS)
- (HCO3) = 22-26mmol/L (MEQ/L)
- <22 = METABOLIC ACIDOSIS
>26 = METABOLIC ALKALOSIS
4. DETERMINE WHICH IS THE PRIMARY AND
COMPENSATING DISORDER
- pH= 7.35-7.45
5. DETERMINE THE DEGREE OF COMPENSATIONS
a. Non-Compensatory
b. Partial Compensation
c. Complete compensation
- 7.31-7.34 = ACIDOSIS
- 7.46-7.49 = ALKALOSIS
PARTIAL: implies that the pH is approaching normal
COMPLETE: implies that the pH has returned to the
normal range

6. EVALUATE THE DEGREE OF OXYGENATION

- PO2 = 80-100mmhg (adequate
oxygenation)
- HYPOXEMIA
 MILD = 60-79mmhg
 MODERATE = 40-59mmhg
 SEVERE = 39 mmhg or less

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