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__NOTOC__
__NOTOC__
==Blood Gas Analysis==
 
{|
[[Sandbox: wdx]]
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Blood gas analysis
 
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Vessel
[[Xyz]]
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Range
 
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Interpretation
[[Abc]]
# [[Sandbox:Preeti]]
# [[Lymphoma]]
# [[Breast lumps differential diagnosis]]
# [[Neck masses differential diagnosis]]
# [[Leukemia]]
{| class="wikitable"
|+
|-
| colspan="2" |[[:Category:Risk calculator]]
[[Category:Risk calculator]]
|-
| colspan="2" |[[Deep vein thrombosis assessment of clinical probability and risk scores]]
|-
| colspan="2" |[[Pulmonary embolism assessment of clinical probability and risk scores]]
|-
|[[Padua prediction score]]
|[[widget:PaduaVTEscore]]
|-
|[[IMPROVE risk score calculator]]
|[[Widget:IMPROVEScore]]
|-
|[[IMPROVEDD risk score calculator]]
|[[Widget:IMPROVEDDScore]]
|-
|[[Caprini score calculator]]
|[[Widget:CapCal]]
|-
|[[Wells score calculator for DVT]]
|[[Widget:DVT Wells score calculator]]
|-
|[[Modified Wells score calculator for DVT]]
|[[Widget:DVT Modified Wells score calculator]]
|-
|-
! rowspan="3" align="center" style="background:#DCDCDC;" + |Oxygen Partial Pressure (pO<sub>2</sub>)
|[[Pulmonary embolism Wells score calculator]]
| rowspan="2" align="center" style="background:#DCDCDC;" + |[[Artery|Arterial]]  
|[[widget:PE_calculator]]
| align="left" style="background:#F5F5F5;" + |80 to 100 mmHg
| align="left" style="background:#F5F5F5;" + |Normal
|-
|-
| align="left" style="background:#F5F5F5;" + |<80  mmHg
|[[Pulmonary embolism modified Wells score calculator]]
| align="left" style="background:#F5F5F5;" + |[[Hypoxemia|Hypoxia]]
|[[Widget:PE Modified Wells score calculator]]
|-
|-
| align="center" style="background:#DCDCDC;" + |[[Vein|Venous]]
|[[AMUSE score calculator]]
| align="left" style="background:#F5F5F5;" + |35 to 40 mmHg
|[[Widget:AMUSE_score_calculator]]
| align="left" style="background:#F5F5F5;" + |Normal
|-
|-
! rowspan="3" align="center" style="background:#DCDCDC;" + |Oxygen Saturation (SO<sub>2</sub>)
|[[HAMILTON score calculator]]
| rowspan="2" align="center" style="background:#DCDCDC;" + |[[Artery|Arterial]]  
|[[Widget:HAMILTON_score_calculator]]
| align="left" style="background:#F5F5F5;" + |>95%
| align="left" style="background:#F5F5F5;" + |Normal
|-
|-
| align="left" style="background:#F5F5F5;" + |<95%
|[[Geneva score calculator]]
| align="left" style="background:#F5F5F5;" + |[[Hypoxemia|Hypoxia]]
|[[Widget:Geneva_score_calculator]]
|-
|-
| align="center" style="background:#DCDCDC;" + |[[Vein|Venous]]
|[[Revised Geneva score calculator]]
| align="left" style="background:#F5F5F5;" + |70 to 75%
|[[Widget:Revised_Geneva_score_calculator]]
| align="left" style="background:#F5F5F5;" + |Normal
|-
|-
! rowspan="4" align="center" style="background:#DCDCDC;" + |[[pH]]
|[[Simplified Geneva Score calculator]]
| rowspan="3" align="center" style="background:#DCDCDC;" + |[[Artery|Arterial]]
|[[Widget:Simplified_Geneva_score_calculator]]
| align="left" style="background:#F5F5F5;" + |<7.35
| align="left" style="background:#F5F5F5;" + |[[Acidosis|Acidemia]]
|-
|-
| align="left" style="background:#F5F5F5;" + |7.35 to 7.45
|[[TIMI Risk Score for Unstable Angina or NSTEMI]]
| align="left" style="background:#F5F5F5;" + |Normal
|[[Widget:TIMI_UA_NSTEMI]]
|-
|-
| align="left" style="background:#F5F5F5;" + |>7.45
|[[TIMI Risk Score for STEMI]]
| align="left" style="background:#F5F5F5;" + |[[Alkalosis|Alkalemia]]
|[[Widget:TIMI_STEMI]]
|-
|-
| align="center" style="background:#DCDCDC;" + |[[Vein|Venous]]
|[[Tygerberg score]]
| align="left" style="background:#F5F5F5;" + |7.26 to 7.46
|[[widget:Tygerberg_score]]
| align="left" style="background:#F5F5F5;" + |Normal
|-
|-
! rowspan="4" align="center" style="background:#DCDCDC;" + |[[Carbon dioxide|Carbon Dioxide]] Partial Pressure ([[PCO2|pCO<sub>2</sub>]])
|[[CHA2DS2-VASc Score]]
| rowspan="3" align="center" style="background:#DCDCDC;" + |[[Artery|Arterial]]
|[[Widget:CHA2DS2VASc]]
| align="left" style="background:#F5F5F5;" + |<35 mmHg
| align="left" style="background:#F5F5F5;" + |Low
|-
|-
| align="left" style="background:#F5F5F5;" + |35 to 45 mmHg
|[[CHADS2 score]]
| align="left" style="background:#F5F5F5;" + |Normal
|[[Widget:CHADS2score]]
|-
|-
| align="left" style="background:#F5F5F5;" + |>45 mmHg
|[[HAS-BLED score]]
| align="left" style="background:#F5F5F5;" + |High
|[[Widget:HASBLEDscore]]
|-
|-
| align="center" style="background:#DCDCDC;" + |[[Vein|Venous]]
|[[The GRACE risk score]]
| align="left" style="background:#F5F5F5;" + |40 to 45 mmHg
|[[Widget:GRACEscore]]
| align="left" style="background:#F5F5F5;" + |Normal
|-
|-
! rowspan="4" align="center" style="background:#DCDCDC;" + |[[Bicarbonate]] ([[Bicarbonate|HCO<sub><big>3</big></sub>]]<sup>−</sup>)
|
| rowspan="3" align="center" style="background:#DCDCDC;" + |[[Artery|Arterial]]
|
| align="left" style="background:#F5F5F5;" + |<22 mmol/L
| align="left" style="background:#F5F5F5;" + |Low
|-
|-
| align="left" style="background:#F5F5F5;" + |22 to 26 mmol/L
|[[Ranson criteria]]
| align="left" style="background:#F5F5F5;" + |Normal
[[Acute pancreatitis diagnostic criteria]]
|[[Widget:RansonScore]]
|-
|-
| align="left" style="background:#F5F5F5;" + |>26 mmol/L
|[[Apgar score]]
| align="left" style="background:#F5F5F5;" + |High
|[[Widget:Apgarscore]]
|-
|-
| align="center" style="background:#DCDCDC;" + |[[Vein|Venous]]
|[[Glasgow coma scale]]
| align="left" style="background:#F5F5F5;" + |19 to 28 mmol/L
|[[Widget:Adult_GCS]]
| align="left" style="background:#F5F5F5;" + |Normal
|-
|-
! rowspan="4" align="center" style="background:#DCDCDC;" + |Base Excess (BE)
|[[Pediatric Glasgow Coma Scale]]
| rowspan="3" align="center" style="background:#DCDCDC;" + |[[Artery|Arterial]]
|[[Widget:PGCS]]
| align="left" style="background:#F5F5F5;" + |<−3.4
| align="left" style="background:#F5F5F5;" + |[[Acidosis|Acidemia]]
|-
|-
| align="left" style="background:#F5F5F5;" + |−3.4 to +2.3 mmol/L
|[[Cincinnati stroke scale]]
| align="left" style="background:#F5F5F5;" + |Normal
|[[Widget:Cincinnati_Stroke_Scale]]
|-
|-
| align="left" style="background:#F5F5F5;" + |>2.3
|[[DIPSS Plus Score]]
| align="left" style="background:#F5F5F5;" + |[[Alkalosis|Alkalemia]]
|[[Widget:DIPSS_Plus_Score]]
|-
|-
| align="center" style="background:#DCDCDC;" + |[[Vein|Venous]]
| colspan="2" |[[ICU scoring systems]]
| align="left" style="background:#F5F5F5;" + |−2 to −5 mmol/L
| align="left" style="background:#F5F5F5;" + |Normal
|-
|-
! colspan="2" align="center" style="background:#DCDCDC;" + |Osmolar gap = Osmolality – Osmolarity
|[[APACHE II]]
| align="left" style="background:#F5F5F5;" + |>10
|[[Widget:APACHEII]]
| align="left" style="background:#F5F5F5;" + |Abnormal
|-
|-
! colspan="2" rowspan="3" align="center" style="background:#DCDCDC;" + |[[Anion gap]]<nowiki> = [[[Sodium|Na]]</nowiki><sup>+</sup><nowiki>] – {[[[Chloride|Cl]]</nowiki><sup>−</sup><nowiki>]+[[[Bicarbonate|HCO</nowiki><sub><big>3</big></sub>]]<sup>−</sup>]}
|[[SAPS II]]
Corrected [[Anion gap|AG]] = (measured serum [[Anion gap|AG]]) + (2.5 x [4.5 − [[Albumin|Alb]]])
|[[Widget:SAPSII]]
| align="left" style="background:#F5F5F5;" + |<8
| align="left" style="background:#F5F5F5;" + |Low
|-
|-
| align="left" style="background:#F5F5F5;" + |8 to 16
|[[SAPS III]]
| align="left" style="background:#F5F5F5;" + |Normal
|[[Widget:SAPSIII]]
|-
|-
| align="left" style="background:#F5F5F5;" + |>16
|[[PIM2]]
| align="left" style="background:#F5F5F5;" + |High
|
|}
|}
 
==Table==
== Compensation ==
* There are compensation mechanisms in the body in order to normalizing the pH inside the blood.<ref name="pmid20859488">{{cite journal |vauthors=Sood P, Paul G, Puri S |title=Interpretation of arterial blood gas |journal=Indian J Crit Care Med |volume=14 |issue=2 |pages=57–64 |date=April 2010 |pmid=20859488 |pmc=2936733 |doi=10.4103/0972-5229.68215 |url=}}</ref>
* The amount of compensation depends on proper functioning of renal and respiratory systems. However, it is uncommon to compensate completely. Compensatory mechanisms might correct only 50–75% of pH to normal.
* Acute respiratory compensation usually occurs within first day. However, chronic respiratory compensation takes 1 to 4 days to occur.
* Renal compensation might occur slower than respiratory compensation.
{|
{|
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Primary disorder
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Complications
! align="center" style="background:#4479BA; color: #FFFFFF;" + |pH
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Polymyositis
! align="center" style="background:#4479BA; color: #FFFFFF;" + |PaCO<sub>2</sub>
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Dermatomyositis
! align="center" style="background:#4479BA; color: #FFFFFF;" + |[HCO3<sup>−</sup>]
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Compensation
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Compensation formula
|-
|-
! align="center" style="background:#DCDCDC;" + |[[Metabolic acidosis]]
! align="center" style="background:#DCDCDC;" + |[[Cancer|Malignancy]]
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + |↓
| align="left" style="background:#F5F5F5;" + |Respiratory
| align="left" style="background:#F5F5F5;" + |
| align="left" style="background:#F5F5F5;" + |
* Expected paCO<sub>2</sub> = 1.5 x serum HCO<sub><big>3</big></sub><sup>−</sup> + 8 ± 2 ([[Winters' formula]])
*[[Lung]]
* Expected paCO<sub>2</sub> = Serum HCO<sub><big>3</big></sub><sup>−</sup> + 15
| align="left" style="background:#F5F5F5;" + |
*[[Lung]]
|}
<br>
===Calculation of the Padua Prediction Score===
Shown below is a calculator using the predictive score for VTE among hospitalized medical patients. Check all boxes that apply to your patient:
 
{| style="border: 0; float: left; width: 45%; position: float; background: #104E8B; border-radius: 10px 10px 10px 10px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5); margin: 0 0 0 0; padding: 5px 5px; font-weight: bold;"
| colspan="2" style="text-align: center; color: #FFFFFF; font-size: 120%;" | IMPROVE Bleeding Risk Score
|-
|-
! align="center" style="background:#DCDCDC;" + |[[Metabolic alkalosis]]
! style=" text-align: left; color: #4479BA; background: #FFFFFF; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 0 0 rgba(0, 0, 0, 0.2); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Variable
| align="center" style="background:#F5F5F5;" + |↑
! style=" text-align: center; color: #4479BA; background: #FFFFFF; border-radius: 5px 5px 5px 5px; text-shadow: 0 0 0 rgba(0, 0, 0, 0.2); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Score
| align="center" style="background:#F5F5F5;" + |↑
|-
| align="center" style="background:#F5F5F5;" + |↑
! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Active gastric or duodenal ulcer
| align="left" style="background:#F5F5F5;" + |Respiratory
| style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |4.5
| align="left" style="background:#F5F5F5;" + |
|-
* Expected paCO<sub>2</sub> = 0.5 − 1 increase/ every 1 unit increase in serum HCO<sub><big>3</big></sub><sup>−</sup> from 24
! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Prior bleeding within the last 3 months
| style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |4
|-
! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Thrombocytopenia (<50x10<sup>9</sup>/L)
| style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |4
|-
! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Age ≥ 85 years
| style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |3.5
|-
! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Liver failure (INR>1.5)
| style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |2.5
|-
! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Severe kidney failure (GFR< 30 mL/min/m<sup>2</sup>)
| style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |2.5
|-
! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Admission to ICU or CCU
| style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |2.5
|-
! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Central venous catheter
| style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |2
|-
! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Rheumatic disease
| style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |2
|-
! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Active malignancy
| style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |2
|-
! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Age: 40-84 years
| style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |1.5
|-
! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Male
| style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |1
|-
! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Moderate kidney failure (GFR: 30-59 mL/min/m<sup>2</sup>)
| style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |1
|-
|-
! align="center" style="background:#DCDCDC;" + |[[Respiratory acidosis]]
! colspan="2" style=" text-align: left; color: #4479BA; background: #FFFFFF; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 0 0 rgba(0, 0, 0, 0.2); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Result:
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + |↑
| align="center" style="background:#F5F5F5;" + |↑
| align="left" style="background:#F5F5F5;" + |Renal
| align="left" style="background:#F5F5F5;" + |
* Acute: HCO<sub><big>3</big></sub><sup>−</sup>  increases by 1mEq/L for every 10 mmHg increase in paCO2 above 40 
* Chronic: HCO<sub><big>3</big></sub><sup>−</sup>  increases by 3.5mEq/L for every 10 mmHg increase in paCO2 above 40
|-
|-
! align="center" style="background:#DCDCDC;" + |[[Respiratory alkalosis]]
! colspan="2" style=" text-align: left; color: #4479BA; background: #FFFFFF; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 0 0 rgba(0, 0, 0, 0.2); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Interpretation:  
| align="center" style="background:#F5F5F5;" + |↑
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + |↓
| align="left" style="background:#F5F5F5;" + |Renal
| align="left" style="background:#F5F5F5;" + |
* Acute: HCO<sub><big>3</big></sub><sup>−</sup>  decreases by 2mEq/L for every 10 mmHg derease in paCO2 above 40 
* Chronic: HCO<sub><big>3</big></sub><sup>−</sup> decreases by 5mEq/L for every 10 mmHg decrease in paCO2 above 40
|}
|}
<br style="clear:left" />


==Approach to acid–base disorders==
===Calculation of the test Prediction Score===
{{familytree/start |summary=Sample 1}}
Shown below is a calculator using the predictive score for VTE among hospitalized medical patients. Check all boxes that apply to your patient:
{{familytree | | | | | | | | A01 |A01=Check [[pH]] on ABG}}
{{familytree | | | | |,|-|-|-|^|-|-|-|-|.| | | }}
{{familytree | | | B01 | | | | | | | |B02| | |B01=pH < 7.35= '''[[Acidosis]]'''|B02=pH > 7.45= '''[[Alkalosis]]'''}}
{{familytree | | | |!| | | | | | | | | |!| }}
{{familytree | | | C01 | | | | | | | | |!| |C01=Check PaCO<sub>2</sub>}}
{{familytree | |,|-|^|.| | | | | | | | |!| }}
{{familytree | D01 | | D02 | | | | | | D03 |D01=PaCO<sub>2</sub> > 45mm Hg = <br>'''[[Respiratory acidosis]]'''|D02=PaCO<sub>2</sub> Normal or < 35mm Hg = <br>'''[[Metabolic acidosis]]'''|D03=Check PaCO<sub>2</sub>}}
{{familytree | | | | | | | | | | | |,|-|^|.| }}
{{familytree | | | | | | | | | | |E02| | E03 | |E02=PaCO<sub>2</sub> > 45mm Hg = <br>'''[[Metabolic alkalosis]]'''|E03=PaCO<sub>2</sub> < 35mm Hg = <br>'''[[Respiratory alkalosis]]'''}}
{{familytree | | | | | | | | | | |!| | | | |!| }}
{{familytree | | | | | | | | | | F01 | | | F02 |F01=[HCO<sub>3</sub><sup>-</sup>] > 29|F02=Check [HCO<sub>3</sub><sup>-</sup>]}}
{{Familytree | | | | | | | | | | | | |,|-|-|^|-|-|.| | }}
{{Familytree | | | | | | | | | | | |C01 | | | | C02 |C01= Normal or slight decrease = <br>'''Acute [[respiratory alkalosis]]'''| C02= Decreased < 24 = <br>'''Chronic [[respiratory alkalosis]]'''}}
{{familytree/end}}


== Mixed Acid−Base Disorders ==
{| style="border: 0; float: left; width: 45%; position: float; background: #104E8B; border-radius: 10px 10px 10px 10px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5); margin: 0 0 0 0; padding: 5px 5px; font-weight: bold;"
{| class="wikitable"
| colspan="2" style="text-align: center; color: #FFFFFF; font-size: 120%;" | IMPROVE Bleeding Risk Score
!Disorder
|-
!Key features
! style=" text-align: left; color: #4479BA; background: #FFFFFF; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 0 0 rgba(0, 0, 0, 0.2); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Variable
!Examples
! style=" text-align: center; color: #4479BA; background: #FFFFFF; border-radius: 5px 5px 5px 5px; text-shadow: 0 0 0 rgba(0, 0, 0, 0.2); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Score
|-
! rowspan="2" style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Gender
| style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Female
|-
| style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Male
|-
! rowspan="4" style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Age
| style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |0-70
|-
| style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |71-80
|-
| style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |81-90
|-
| style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |>90
|-
! rowspan="5" style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Hgb ('''g/dL)'''
| style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |>17 '''g/dL'''
|-
| style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |15.5-17 '''g/dL'''
|-
| style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |12.5-15.5 '''g/dL'''
|-
| style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |12.5-11 '''g/dL'''
|-
| style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |<11 '''g/dL'''
|-
! rowspan="2" style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |CrCl (mL/min)
| style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |30-60 mL/min
|-
| style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |15-30 mL/min
|-
! rowspan="2" style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Albumin
| style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |>3.5 g/dL
|-
| style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |≤3.5 g/dL
|-
! rowspan="2" style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |D-dimer
| style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |≥1 µg/mL
|-
|-
|Metabolic acidosis & respiratory alkalosis
| style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |<1 µg/mL
|
* High− or normal−AG metabolic acidosis
* Prevailing PaCO<sub>2</sub> below predicted value  
|
* Lactic acidosis
* Sepsis in ICU
|-
|-
|Metabolic acidosis & respiratory acidosis
! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |ICU admission
|
| style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |
* High− or normal−AG metabolic acidosis
* Prevailing PaCO<sub>2</sub> above predicted value 
|
* Severe pneumonia
* Pulmonary edema  
|-
|-
|Metabolic alkalosis & respiratory alkalosis
! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Acute stroke on hospitalization
|
| style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |
* PaCO<sub>2</sub> does not increase as predicted
* pH higher than expected
|
* Liver disease
* Diuretics
|-
|-
|Metabolic alkalosis & respiratory acidosis
! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |History of VTE
|
| style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |
* PaCO<sub>2</sub> higher than predicted
* pH normal
|
* COPD on diuretics
|-
|-
|Metabolic acidosis & metabolic alkalosis
! colspan="2" style=" text-align: left; color: #4479BA; background: #FFFFFF; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 0 0 rgba(0, 0, 0, 0.2); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Result:
|
* Only detectable with high−AG acidosis
* ∆AG >> ∆[HCO<sub><big>3</big></sub><sup>−</sup>]
|
* Uremia with vomiting
|-
|-
|Metabolic acidosis & metabolic acidosis
! colspan="2" style=" text-align: left; color: #4479BA; background: #FFFFFF; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 0 0 rgba(0, 0, 0, 0.2); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Interpretation:
|
* Mixed high−AG & normal−AG acidosis
* ∆[HCO<sub><big>3</big></sub><sup>−</sup>] accounted for by combined change in ∆AG and ∆Cl<sup>−</sup>
|
* Diarrhea and lactic acidosis
* Toluene toxicity
* Treatment of diabetic ketoacidosis
|}
|}
<br style="clear:left" />


==Related Chapters==
===Interpretation of the Padua Prediction Score===
* [[Acid-base homeostasis|Acid–base homeostasis]]
The interpretation of the score is as follows:
* [[Acid-base imbalance|Acid–base imbalance]]
* Score ≥ 4: High risk for VTE
* [[Acidosis]]
* Score < 4: Low risk for VTE
* [[Alkalosis]]
==References==
* [[Arterial blood gas]]
* [[Metabolic acidosis]]
* [[Metabolic alkalosis]]
* [[Respiratory acidosis]]
* [[Respiratory alkalosis]]
* [[Anion gap]]
<references />
<references />

Latest revision as of 18:11, 14 January 2019


Sandbox: wdx

Xyz

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Category:Risk calculator
Deep vein thrombosis assessment of clinical probability and risk scores
Pulmonary embolism assessment of clinical probability and risk scores
Padua prediction score widget:PaduaVTEscore
IMPROVE risk score calculator Widget:IMPROVEScore
IMPROVEDD risk score calculator Widget:IMPROVEDDScore
Caprini score calculator Widget:CapCal
Wells score calculator for DVT Widget:DVT Wells score calculator
Modified Wells score calculator for DVT Widget:DVT Modified Wells score calculator
Pulmonary embolism Wells score calculator widget:PE_calculator
Pulmonary embolism modified Wells score calculator Widget:PE Modified Wells score calculator
AMUSE score calculator Widget:AMUSE_score_calculator
HAMILTON score calculator Widget:HAMILTON_score_calculator
Geneva score calculator Widget:Geneva_score_calculator
Revised Geneva score calculator Widget:Revised_Geneva_score_calculator
Simplified Geneva Score calculator Widget:Simplified_Geneva_score_calculator
TIMI Risk Score for Unstable Angina or NSTEMI Widget:TIMI_UA_NSTEMI
TIMI Risk Score for STEMI Widget:TIMI_STEMI
Tygerberg score widget:Tygerberg_score
CHA2DS2-VASc Score Widget:CHA2DS2VASc
CHADS2 score Widget:CHADS2score
HAS-BLED score Widget:HASBLEDscore
The GRACE risk score Widget:GRACEscore
Ranson criteria

Acute pancreatitis diagnostic criteria

Widget:RansonScore
Apgar score Widget:Apgarscore
Glasgow coma scale Widget:Adult_GCS
Pediatric Glasgow Coma Scale Widget:PGCS
Cincinnati stroke scale Widget:Cincinnati_Stroke_Scale
DIPSS Plus Score Widget:DIPSS_Plus_Score
ICU scoring systems
APACHE II Widget:APACHEII
SAPS II Widget:SAPSII
SAPS III Widget:SAPSIII
PIM2

Table

Complications Polymyositis Dermatomyositis
Malignancy


Calculation of the Padua Prediction Score

Shown below is a calculator using the predictive score for VTE among hospitalized medical patients. Check all boxes that apply to your patient:

IMPROVE Bleeding Risk Score
Variable Score
Active gastric or duodenal ulcer 4.5
Prior bleeding within the last 3 months 4
Thrombocytopenia (<50x109/L) 4
Age ≥ 85 years 3.5
Liver failure (INR>1.5) 2.5
Severe kidney failure (GFR< 30 mL/min/m2) 2.5
Admission to ICU or CCU 2.5
Central venous catheter 2
Rheumatic disease 2
Active malignancy 2
Age: 40-84 years 1.5
Male 1
Moderate kidney failure (GFR: 30-59 mL/min/m2) 1
Result:
Interpretation:


Calculation of the test Prediction Score

Shown below is a calculator using the predictive score for VTE among hospitalized medical patients. Check all boxes that apply to your patient:

IMPROVE Bleeding Risk Score
Variable Score
Gender Female
Male
Age 0-70
71-80
81-90
>90
Hgb (g/dL) >17 g/dL
15.5-17 g/dL
12.5-15.5 g/dL
12.5-11 g/dL
<11 g/dL
CrCl (mL/min) 30-60 mL/min
15-30 mL/min
Albumin >3.5 g/dL
≤3.5 g/dL
D-dimer ≥1 µg/mL
<1 µg/mL
ICU admission
Acute stroke on hospitalization
History of VTE
Result:
Interpretation:


Interpretation of the Padua Prediction Score

The interpretation of the score is as follows:

  • Score ≥ 4: High risk for VTE
  • Score < 4: Low risk for VTE

References

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