Pathophysiologic Basis of Acid-Base Disorders

Description

The book is a concise and informative text about acid-base disorders. The book begins with very simple mathematics, chemistry, and physiological concepts and smoothly connects these to various aspects of acid-base disturbances and blood gas disorders through many simple-to-understand case-based examples. It covers various important topics such as respiratory acidosis and alkalosis, metabolic acidosis and alkalosis, mixed disorders, arterial blood gas, etc. All chapters end with a simple take-home summary facilitating better understanding and recall value. This book showcases practical text important at all levels of medical education, right from a basic science student to an attending physician/surgeon. Students, interns, residents, fellows, and attending physicians working in a broad range of clinical settings, particularly anesthesiology, surgery, and critical care can find this book helpful. Preface Contents About the Author 1: Starting from Scratch 1.1 Calculation with Powers 1.1.1 Multiplication and Division of Numbers Having the Same Base, B 1.1.2 Powers Raised to Powers 1.2 Logarithm 1.3 Chemical Equilibrium 1.3.1 Equilibrium Constant 1.4 Things to Remember References 2: ABC’s of Acid-Base Chemistry 2.1 Ionization of Water 2.2 pH, pOH, pK, pKw 2.3 Acids and Bases 2.4 Buffers 2.4.1 Buffering Action 2.4.2 Titration and Titration Curve 2.4.3 Amino Acids as Buffers 2.5 Things to Remember References 3: Gas Laws 3.1 Pressure and Partial Pressure of a Gas 3.2 Dalton’s Law of Partial Pressure 3.3 Composition of Alveolar Air 3.4 Gas-Liquid Equilibrium 3.5 Henry’s Law 3.6 Things to Remember References 4: What Happens in a Person 4.1 Introduction 4.2 Pulmonary Ventilation, Perfusion, and Blood-Gas Exchange 4.2.1 Ventilation 4.2.1.1 Regional Distribution of Ventilation 4.2.2 Perfusion and Its Regional Distribution 4.2.3 Regional Variation in the Matching of Ventilation and Perfusion 4.3 Blood-Gas Interface and Gas Exchange 4.4 Respiratory Quotient 4.5 Alveolar Air Composition 4.6 Carriage of O2 by the Blood 4.6.1 Oxyhemoglobin Dissociation Curve 4.6.1.1 Factors Affecting the Oxyhemoglobin Dissociation Curve 4.7 Carriage of Carbon Dioxide 4.8 Control of Respiration 4.9 Buffers 4.9.1 Bone as a Buffer 4.10 Renal Regulation of Extracellular Hydrogen Ion Concentration 4.10.1 Bicarbonate Reabsorption 4.10.2 Addition of New Bicarbonate to the Plasma and Renal Excretion of Acid 4.11 Things to Remember References 5: Introduction to Acid-Base Chemistry and Arterial Blood Gases 5.1 Terminology 5.2 Bedside Approach to a Patient with a Suspected Acid-Base Disorder 5.3 Indications for Arterial Blood Gas Analysis 5.4 Obtaining the Sample 5.4.1 Allen’s Test 5.4.2 Complications of Arterial Puncture and Cannulation 5.5 Analysis of the Sample 5.6 Venous Blood Gas Analysis 5.7 Anion Gap 5.8 Base Excess (BE) 5.9 Normal Values 5.10 Bicarbonate Space 5.11 Systemic Effects of Acidemia 5.12 Systemic Effects of Alkalemia 5.13 Things to Remember References 6: Respiratory Acidosis and Alkalosis 6.1 Causes of Respiratory Acidosis and Alkalosis 6.2 Mechanisms in Respiratory Acidosis 6.2.1 Acute Phase of Respiratory Acidosis 6.2.2 Chronic Phase of Respiratory Acidosis 6.3 Clinical Manifestations of Respiratory Acidosis 6.4 Diagnosis of Respiratory Acidosis 6.5 Treatment of Respiratory Acidosis 6.6 Mechanisms in Respiratory Alkalosis 6.6.1 Acute Phase of Respiratory Alkalosis 6.6.2 Chronic Phase of Respiratory Alkalosis 6.7 Clinical Manifestations of Respiratory Alkalosis 6.8 Diagnosis of Respiratory Alkalosis 6.9 Treatment of Respiratory Alkalosis 6.10 Things to Remember References 7: Metabolic Acidosis and Alkalosis 7.1 Pathogenesis and Compensatory Mechanisms 7.1.1 Metabolic Acidosis 7.1.2 Metabolic Alkalosis 7.2 Causes of Metabolic Acidosis 7.2.1 Over-Production of Fixed Acid 7.2.2 Loss of Buffer Stores (Bicarbonate Wasting) 7.2.3 Decreased Normal Renal Acid Excretion 7.3 Causes of Metabolic Alkalosis 7.4 Systemic Manifestations of Metabolic Acidosis 7.5 Systemic Manifestations of Metabolic Alkalosis 7.6 Diagnosis of Metabolic Acidosis 7.7 Treatment of Metabolic Acidosis 7.7.1 Complications of Sodium Bicarbonate Therapy 7.8 Diagnosis of Metabolic Alkalosis 7.9 Treatment of Metabolic Alkalosis 7.9.1 Saline (Chloride) Responsive Alkalosis 7.9.2 Saline (Chloride) Unresponsive Alkalosis 7.10 Things to Remember References 8: Mixed Disorders 8.1 Introduction and Diagnostic Procedures 8.2 Clinical Approach to Mixed Acid-Base Disorders 8.3 Mixed Acid-Base Disorders 8.3.1 Mixed Metabolic and Respiratory Acidosis 8.3.1.1 Treatment 8.3.2 Mixed Metabolic Acidosis and Respiratory Alkalosis 8.3.2.1 Treatment 8.3.3 Mixed Metabolic Acidosis 8.3.3.1 Mixed Hyperchloremic (Normal-AG) and High-AG Metabolic Acidosis 8.3.3.2 Mixed High-AG Metabolic Acidosis 8.3.3.3 Mixed Hyperchloremic Metabolic Acidosis (ΔAG = 0) 8.3.4 Mixed Metabolic Acidosis and Metabolic Alkalosis 8.3.5 Mixed Metabolic Alkalosis and Respiratory Acidosis; Mixed Metabolic and Respiratory Alkalosis 8.3.6 Mixed Acute and Chronic Respiratory Acidosis or Alkalosis 8.3.7 Triple Acid-Base Disorders 8.4 Things to Remember References 9: Arterial Blood Gas 9.1 Hypoxia and Its Causes 9.1.1 Ventilation-Perfusion () Mismatch 9.1.2 Blood Shunt 9.1.3 Hypoventilation 9.1.4 Thickening of Blood-Gas Interface 9.2 Oxyhemoglobin Dissociation Curve 9.3 Things to Remember References