Kuntarti, SKp
Distribusi cairan tubuh - cairan intrasel (CIS) = 2/3 cairan tubuh - cairan ekstrasel (CES) = 1/3 cairan tubuh * intravaskular (plasma) = 25% CES * intersisial = 75% CES
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Tekanan Cairan
1. Tekanan osmotik & onkotik
Tekanan osmotik: tekanan untuk mencegah aliran osmotik cairan Tekanan onkotik: gaya tarik s/ koloid agar air tetap berada dalam plasma darah di intravaskular
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Permeabilitas membran sel bersifat selektif terhadap: ion (kanal ion), air (aquaporin)
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Peranan ginjal
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Peranan Atriopeptin
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Peranan Renin-Angiotensin-Aldosteron
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Peranan Vasopresin
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- Angiotensin II reabsorpsi Na - Aldosteron reabsorpsi Na - Antidiuretic hormone (ADH) reabsorpsi air - Atrial natriuretic peptide (ANP/atriopeptin) ekskresi Na & air
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[H+] dlm plasma pH plasma darah = 7,4 Sistem dapar (buffer) menghambat perubahan pH yang besar jika ada penambahan asam atau basa
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Sistem Dapar
1. Asam karbonat:Bikarbonat sistem dapar di CES untuk asam nonkarbonat 2. Protein sistem dapar di CIS & CES 3. Hemoglobin sistem dapar di eritrosit untuk asam karbonat 4. Phosphat sistem dapar di ginjal dan CIS
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Keseimbangan ion
+ H
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Nomogram Davenport
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INTERPRETASI AGD
Lihat pH darah
pH < 7,35
pH > 7,45
ASIDOSIS
ALKALOSIS
Lihat pCO2
Lihat HCO3-
< 40mmHg
> 40 mmHg
< 24 mM
> 24 mM
METABOLIK
RESPIRATORIK RESPIRATORIK
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METABOLIK
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LATIHAN
pH 7.32, PCO2 40, HCO3 19 pH 7.55, PCO2 20, HCO3 22 pH 7.55, PCO2 37, HCO3 30 pH 7.49, PCO2 35, HCO3 29 pH 7.30, PCO2 50, HCO3 29 pH 7.43, PCO2 53, HCO3 30 pH 7.44, PCO2 38, HCO3 26 pH 7.43, PCO2 32, HCO3 20
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Asidosis metabolik tdk terkompensasi Alkalosis respiratorik tdk terkompensasi Alkalosis metabolik tdk terkompensasi
normal
Alkalosis respiratorik terkompensasi
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