MD Ramon C. Henson
A Normal-Looking Blood Gas Can Hide Two Life-Threatening Problems at Once - Learn to Find Both Built for the resident reading a first arterial blood gas and the intensivist managing a patient with four simultaneous acid-base processes, this handbook connects buffer chemistry and renal-pulmonary regulation directly to bedside decisions. It develops a systematic, five-step diagnostic sequence and teaches exactly when to trust the traditional anion-gap approach versus the Stewart physicochemical framework, reconciling a debate most references leave unresolved. Every chapter moves from mechanism to the specific decision it demands. Worked clinical cases and a cross-referenced quick-decision atlas turn dense physiology into a repeatable bedside workflow. In This Handbook, You Will Learn How To Apply buffer chemistry and the renal-pulmonary axis - Henderson-Hasselbalch and net acid excretion explained as mechanism, not memorized as isolated formulas. Choose between the traditional and Stewart frameworks - a five-part comparison repeated throughout, showing exactly when strong-ion accounting earns its added complexity. Run the complete five-step blood gas sequence - anion gap correction, delta-delta analysis, and compensation checks that catch a second hidden process before it’s missed. Distinguish euglycemic DKA, toxic alcohol ingestion, and metformin-associated lactic acidosis - mechanism-based differentials that don’t rely on glucose or history alone. Separate chloride-responsive from chloride-resistant alkalosis - urine chloride interpretation, Bartter and Gitelman syndrome, and hyperaldosteronism worked to a specific diagnosis. Interpret a blood gas on ECMO, CRRT, or in the operating room - circuit-driven PaCO2 and citrate effects decoded so treatment isn’t mistaken for disease. Connect potassium, calcium, and phosphate to acid-base status - coupled mechanisms that turn a scattered electrolyte panel into one diagnostic picture. Reason through genuinely complex, multi-system patients - capstone cases combining ten or more chapters’ tools into a single bedside decision. Keep it within reach for the next blood gas that doesn’t add up - the reasoning your sickest patients depend on, in one reference.
