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Blood gas analysis: Acid–base, fluid, and electrolyte disorders 

Blood gas analysis: Acid–base, fluid, and electrolyte disorders
Blood gas analysis: Acid–base, fluid, and electrolyte disorders
The ESC Textbook of Intensive and Acute Cardiovascular Care (2 ed.)

Richard Paul

and Paul Grant

Previous versions of this chapter are available. To view earlier versions of this chapter view the full site here.

Acid-base homeostasis is vital for the maintenance of normal tissue and organ function, as both acidosis and alkalosis can have harmful and potentially life-threatening effects. Arterial blood gas analysis, combined with routine clinical history and examination, can provide useful information for the management of the critically ill cardiac patient. Most acid-base derangements are reversed by treatment of the underlying disease process, rather than simple correction of the abnormal pH, and prognosis is determined by the nature of the underlying disease, rather than the extent of pH value deviation. Within this chapter, a six-step approach is presented for prompt and accurate acid-base interpretation. Water and electrolyte disorders are common in the intensive cardiac care unit, particularly in patients with cardiac failure. Prompt recognition and treatment is required to prevent cardiovascular and neurological compromise. Therapeutic strategies range from simple electrolyte substitution and fluid management to extracorporeal filtration of excess fluid and electrolytes. These are discussed within this chapter.

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