Step-by step tutorial on how to use Winters' formula to calculate appropriate respiratory compensation in a metabolic acidosis and how to interpret results.
Very nice, and exactly as I have always used this formula, BUT I have seen problems worked by renal experts, who refer to a 2010 paper in the Society of American Nephrologist Journal, who use the "Rule of 5" saying that the ± pC02 is really ± 5. Meaning I have been over calling concomitant respiratory disorders...I find this terribly confusing, but delightfully arcane which is why I love blood gases!
Hi. How can we identify primary disorders if pH is normal? For example, pH is normal, pC02 is low, bicarbonate is low. Is it compensated respiratory alkalosis or compensated metabolic acidosis? Thank you!
If the pH is normal (which would be a rare situation), then there are TWO primary acid-base disorders. Compensation should NOT create a fully normal pH. Hope that helps.
YJ Lin normal ph doesn’t seem like a rare situation, people can fully compensate for metabolic acidosis by breathing faster... but if it gets bad enough and the pt can’t keep up, then they won’t be able to compensate right?
Literally said “OHH” right after inpatient service. Videos like these help me grasp intern year a little better. Thanks
You're very welcome!
Very helpful and clearly explained. Thank you!
You cleared my concept..
Great explanation! I understand winters formula much better now. Thank you. Please post more videos.
I’m glad it help! I’d a tad busy with residency interviews but I’ll try to get more videos up. Any particular topics you’d like to see?
If you're here cause Anki deck had it the other way around ):
which Anki deck?
Great boss . Keep going !!
is there also any way to find for metabplic compensation for respiratory acidosis ??
Thank you so much, you just saved me!
PH 7.1 (normal 7.36-7.44)
Pco2 8.0kpa (normal 4.5-6.0)
Bicarb 15meq/L (normal 24-30)
What is the abnormality?
Help
Excellent, buddy.
🙏🙏🙏🙏🙏❤️
Very nice, and exactly as I have always used this formula, BUT I have seen problems worked by renal experts, who refer to a 2010 paper in the Society of American Nephrologist Journal, who use the "Rule of 5" saying that the ± pC02 is really ± 5. Meaning I have been over calling concomitant respiratory disorders...I find this terribly confusing, but delightfully arcane which is why I love blood gases!
Thank you
But if we use simple formula= predicted Pco2 = measured Hco3 + 15
The values will be different from the one calculated by Winters formula
correct, I would not use that abbreviated formula
thanks!
Very clear! Thx
Glad it helped!
Hi. How can we identify primary disorders if pH is normal? For example, pH is normal, pC02 is low, bicarbonate is low. Is it compensated respiratory alkalosis or compensated metabolic acidosis? Thank you!
If the pH is normal (which would be a rare situation), then there are TWO primary acid-base disorders. Compensation should NOT create a fully normal pH. Hope that helps.
@@linlectures Thank you very much!
YJ Lin normal ph doesn’t seem like a rare situation, people can fully compensate for metabolic acidosis by breathing faster... but if it gets bad enough and the pt can’t keep up, then they won’t be able to compensate right?
Is winter's formula only for metabolic acidosis?
correct
awesome, very well explained. thank you
Glad it was helpful!
Nice video!
THANK YOU!
you're welcome!
noice