hello..i want to ask you all..i have been reading Marino's "The ICU BOOK" for a while now. and i am now reading how to interpret Blood Gas from that book.
now, my confusion is:
1. in stage 1 : rule 3, Marino tells us that " if either the pH or PCO2 is normal, there is mixed metabolic and respiratory acid base disorder"
and...
"if the PCO2 is normal, the direction of change in pH identifies the metabolic disorder"
i don't really understand this...how can he come up with that statement?
for example, pCO2 = 40 ,pH=7.6 , how can he be so sure that it is an alkalosis metabolic (without looking at HCO3 value) combined with respiratory acidosis (as u can see, the pCO2 is still normal)?
2. i noticed that Marino doesn't look HCO3 at all in the first stage (he only use pCO2 and pH)..why?
please help me to understand this..thank you
best regards,Ketap
now, my confusion is:
1. in stage 1 : rule 3, Marino tells us that " if either the pH or PCO2 is normal, there is mixed metabolic and respiratory acid base disorder"
and...
"if the PCO2 is normal, the direction of change in pH identifies the metabolic disorder"
i don't really understand this...how can he come up with that statement?
for example, pCO2 = 40 ,pH=7.6 , how can he be so sure that it is an alkalosis metabolic (without looking at HCO3 value) combined with respiratory acidosis (as u can see, the pCO2 is still normal)?
2. i noticed that Marino doesn't look HCO3 at all in the first stage (he only use pCO2 and pH)..why?
please help me to understand this..thank you
best regards,Ketap