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Compensated and
Uncompensated
Blood Gas Analysis
James Barnett, RN, MSN
Clinical Educator – Neuroscience PCC
Vanderbilt University Medical Center
May 2007
Compensatory Mechanisms
Compensation is the body’s way of restoring a
normal blood pH
Chemical
Respiratory
Renal
Chemical Compensation
Chemicals within the blood act within seconds
to correct respiratory or metabolic imbalances
Used up quickly – not effective long-term
Chemical buffers in the blood include
Bicarbonate
Phosphate
Proteins
Respiratory Compensation
Used to compensate for metabolic imbalances
only
Uncompensated
Partially compensated
Fully compensated
Degrees of Compensation
Uncompensated
Body has made no attempt to correct the acid-base
imbalance
Partially compensated
Body is attempting to correct the imbalance
Blood pH remains abnormal in spite of the attempt
Degrees of Compensation
Fully compensated
Blood pH is normal
If PaCO2 is abnormal
Problem is respiratory
If HCO3- is abnormal
Problem is metabolic
Uncompensated
Imbalance
Uncompensated Uncompensated
respiratory acidosis respiratory alkalosis
Remember that CO2 is an acid and that the more of it there is the worse is
the acidemia. Notice that with uncompensated respiratory, the HCO3 is
normal – this is because the body has not began to compensate for the
alterations in CO2
Uncompensated
Imbalance
Uncompensated Uncompensated
metabolic acidosis metabolic alkalosis
Remember that HCO3 is a base and that the more of it there is the more
alkalotic you will be. Notice that in the case of uncompensated metabolic
the PaCO2 is normal indicating that the body has not began to compensate.
Partially Compensated
Imbalances
Occur when compensation mechanisms are
activated, but have not had sufficient time to
normalize the blood pH
Notice with the mixed acidosis that you have an acidic pH (less than 7.35, with other
Parameters indicating an acid environment. High PaCO2 (too much acid). Low HCO3
(too little base – an acidic environment). This is classic mixed acidosis.
Finished
You have finished this in-service.
Please go to the next in-service titled:
Effects of Acid Base on Oxygenation