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Acid-Base Balance and Blood Gas Analysis

  • Felice Eugenio Agrò
  • Marialuisa Vennari
  • Maria Benedetto
Chapter

Abstract

Cardiac surgery patients may develop alterations of acid-base balance due to cardiac pathology, comorbidities, type and duration of surgery, and CPB. Acid-base status evaluation through ABG is the base for an adequate perioperative treatment. ABG interpretation needs more useful tool than those proposed by Henderson-Hasselbalch approach, such as anion gap, standard base excess, and strong ions difference, in order to identify the underlying acid-base disorders. In this chapter, the physiology and pathophysiology of acid-base balance in cardiac patients and their consequence on perioperative management are described; an overview on ABG interpretation and its relation with diagnostic hypothesis and therapeutic management are presented.

Keywords

The descriptive approach The semiquantitative approach The quantitative approach Relation among fluid Electrolyte and acid-base balance Basis of pathophysiology acid-base balance in the postoperative ICU setting of cardiac surgery Fluid and electrolyte management consequences on acid-base balance Hyperchloremic acidosis Dilution acidosis Metabolizable anions and base excess Crystalloids and acid-base status Colloids and acid-base status Maintaining acid-base balance Arterial blood gas analysis interpretation Boston rules Base excess Standard base excess Anion gap Stewart approach Metabolic acidosis Metabolic alkalosis Respiratory acidosis Respiratory alkalosis 

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© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Felice Eugenio Agrò
    • 1
  • Marialuisa Vennari
    • 1
  • Maria Benedetto
    • 1
  1. 1.Postgraduate School of Anesthesia and Intensive Care, Anesthesia, Intensive Care and Pain Management DepartmentUniversity School of Medicine Campus Bio-Medico of RomeRomeItaly

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