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ANALISIS GAS DARAH

(AGDA)
Dr. Said Aandy Saida
Bagian/SMF Ilmu Penyakit Dalam
FK Unsyiah/RSUDZA Banda Aceh
2016

Apa yang
dibaca ?

pH, PaCO2, BE
HCO3, PaO2,
SaO2

STEPS IN ACIDS BASE


CLASSIFICATION
1. pH Classification
2. PaCO2 Classification
3. Metabolic Classification
4. Compensation Evaluation
5. Complete Acid-Base Classification

pH Classification
Classification

pH

Normal

7.35-7.45

Acidosis

< 7.35

Alkalosis

>7.45

Classification of Laboratory
Respiratory Acid-Base Component
Classification
Normal Resp.Component

PaCO2 (mmHg)
35-45

Respiratory Acidosis

>45

Respiratory Alkalosis

<35

Classification of Laboratory
Metabolic Acid-Base Component
Classification

BE

HCO3

Normal Metab.Component

02

242

Metabolic Acidosis

< -2

<22

Metabolic Alkalosis

> +2

>26

Langkah Langkah

Baca pH normal, acidosis, alkalosis


Lihat PaCO2 atau BE, mana yg searah dengan pH
Bila PaCO2 yang searah respiratorik sebagai
proses primer
Bila BE yang searah metabolik sebagai proses
primer
Bila proses primer sudah diketahui, lihat dimana
posisi komponen yg lain :

Bila berlawanan proses kompensasi


Bila searah proses ganda
Bila posisi normal belum atau tidak ada proses
kompensasi

ACIDOSIS

ALKALOSI
S

7,35

pH

7,45

45

PaCO2

35

-2

BE

+2

22

HCO3

26

pH : 7.28, PaCO2 : 40, BE : -10


ACIDOSIS

pH

7,45

45

PaCO
40 2

35

-2

BE

+2

22

HCO3

26

7.28 7,35
-10

ALKALOSI
S

Acidosis metabolik tanpa

pH : 7.32, PaCO2 : 55, BE : +1


ACIDOSIS

pH

7,45

45

PaCO2

35

-2

BE
+
1
HCO3

+2

7.32 7,35
55

ALKALOSI
S

22

26

Acidosis respiratorik tanpa

pH : 7,50 ; PaCO2 : 30 ; BE : -2 ;

ACIDOSIS

7,35
45

pH

ALKALOSI
S

7,45 7,50

PaCO2 35

-2

BE

+2

22

HCO3

26

Alkalosis respiratorik tanpa


kompensasi

30

pH : 7,55 ; PaCO2 : 30 ; BE : +5 ;

ACIDOSIS

7,35
45

pH

ALKALOSI
S

7,45 7,55

PaCO2 35

-2

BE

+2

22

HCO3

26

30
+5

Alkalosis respiratorik dan metabolik


(proses ganda)

Steps in Evaluation and Classification of


Acid-Base Compensation
1. Evaluate for the presence of compensation
2. Determine the probable primary problem
3. Classify the degree of compensation

Determination of the
primary problem
pH 7.40-7.45

Alkalosis is primary
Acidosis is compensatory

pH 7.35-7.40

Acidosis is primary,
Alkalosis is compensatory

Classification of degree of
Compensation
pH

Degree of compensation

7.35-7.45

Complete

<7.35

Partial

>7.45

Partial

pH : 7,48 ; PaCO2 : 30 ; BE : -6 ;

ACIDOSIS

7,35
45
-6

pH

ALKALOSI
S

7,45 7,48

PaCO2 35

-2

BE

+2

22

HCO3

26

30

Alkalosis respiratorik dgn kompensasi


parsial

pH : 7.32, PaCO2 : 30, BE : -10


ACIDOSIS

pH

7,45

45

PaCO2

35

-2

BE

+2

22

HCO3

26

7.32 7,35
-10

ALKALOSI
S

30

Acidosis metabolik dgn

pH : 7.38, PaCO2 : 30, BE : -10


ACIDOSIS

pH
7,35 7,38
-10

ALKALOSI
S

7,45

45

PaCO2

35

-2

BE

+2

22

HCO3

26

30

Acidosis metabolik dgn

pH : 7,43 ; PaCO2 : 30 ; BE : -6 ;

ACIDOSIS

7,35
-6

ALKALOSI
S

pH7,43 7,45

45

PaCO2

-2

BE

+2

22

HCO3

26

35

30

Alkalosis respiratorik dgn kompensasi


penuh

CLASSIFICATION of PaO2
PaO2 (mmHg)
CLASSIFICATION

Adult

Newborn

Hyperoxemia

>100

>90

Normoxemia

80-100

60-90

Mild hypoxemia

60-79

50-59

Moderate
hypoxemia

45-59

40-49

<45

<40

Severe hypoxemia

Severity of Generalized Acid-Base


disturbances
pH
<7,20
7,20-7,29
7,30-7,34
7,35-7,45
7,46-7,50
7,51-7,55
>7,55

Degree of
Impairment
Severe Acidosis
Moderate
Acidosis
Mild Acidosis
Normal pH
Mild Alkalosis
Moderate

Normal Arterial Gases


Parameter

Values

pH

7,35-7,45

PaCO2

35-45 mmHg

PaO2

80-100 mmHg

SaO2

98-100%

Normal mixed venous gases

Parameter

Values

pH

7,38

PaCO2

48 mmHg

PaO2

40 mmHg

SaO2

75%

No.

pH

PaCO2

HCO3

PaO2

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.

7,58
7,44
7,21
7.44
7,60
7,50
7,41
7,52
7,44
7,44

20
52
66
31
28
50
42
41
28
35

19
34
26
20
27
37
25
32
35
23

63
28
47
111
59
75
229
49
87
97

Classification

No.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.

pH
7.32
7.52
7.36
7.42
7.20
7.20
7.55
7.34
7.37
7.40

PaCO2
30
34
32
30
50
80
25
30
56
38

BE
-10
+4
-4
-5
-9
+2
0
-9
+4
-2

PaO2
58
32
145
90
60
90
72
41
57
350

Classification

Terima Kasih