Zdroje chyb při interpretaci analýzy krevních plynů: Současné acidobazické modely plazmy

Krbec, Martin

Sources of error in interpretation of blood gas analysis: Current acid-base models of plasma Abstract of Doctoral thesis Martin Krbec Introduction. Evaluation of acid-base status is an essential tool used by clinicians to guide therapy in a wide range of conditions. Of all biological fluids, in which the acid-base equilibrium has been studied, isolated plasma is the best described one. For its evaluation, two main approaches have been developed: One is the traditional bicarbonate-centered school based the work of Henderson, Hasselbalch, van Slyke, and Siggaard-Andersen. The other is the quantitative physicochemical approach invented by Stewart and further developed by Staempfli and Constable or Figge and Fencl. Each of the mentioned models uses a set of constants for characterizing the behavior of non-carbonic buffers (proteins and phosphates) in plasma, the value of which is crucial for precise calculation of derived parameters. The values of the constants used by the Stewart model, i.e., the total weak nonvolatile acid concentration (Atot) and its dissociation constant (pKa), have only been experimentally determined once in a group of 8 healthy volunteers. Our aim was to experimentally determine the value of these constants in healthy volunteers and, for the first time ever, in two populations of...

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