Blutgasanalyse beim Hund in der tierärztlichen Praxis – eine Übersicht

Zusammenfassung

Die Blutgasanalyse ist ein nützliches Instrument, um Informationen über den Säuren-Basen-Haushalt (SBH) und den Gasaustausch in der Lunge zu erhalten. Die Interpretation basiert auf der Henderson-Hasselbalch-Gleichung, mit der sich allerdings komplexere Störungen nur unzureichend beschreiben lassen. Basenüberschuss und Anionenlücke ergänzen dieses traditionelle Modell. Peter Stewart entwickelte das Modell der quantitativen Analytik des Säuren-Basen-Haushalts, das zum Strong Ion Approach weiterentwickelt wurde und das sich vor allem bei der Beurteilung von metabolischen Störungen von der traditionellen Sichtweise in vielerlei Hinsicht unterscheidet. Beide Modelle ergänzen sich gegenseitig und haben Vorund Nachteile. Für unkomplizierte Veränderungen des SBH kann der Henderson-HasselbalchAnsatz verwendet werden. Für komplizierte Störungen des SBH, insbesondere bei Veränderungen der Albuminund/oder der Phosphatkonzentration, empfiehlt sich der Einsatz des Strong Ion Approach. Mit dem Verständnis beider Modelle und dem klinischen Bild gelingt eine optimale Therapie der Störungen im SBH.

Summary

Blood gas analysis is useful to obtain information about acid-base state and gas exchange of the lung. Interpretation is based on the Henderson-Hasselbalch equation. This approach has its limitations especially in interpretation of complex disturbances of acid-base status and has been complemented by base excess and anion gap. Peter Stewart described a model of quantitative approach to the acid-base disturbances which has been further developed and is known as the strong ion approach. This model differs from the traditional approach in the assessment of metabolic disorders of acid base status. Both models complement each other but also have their advantages and disadvantages. For simple disorders of the acid-base state the Henderson-Hasselbalch approach can be used, however in complex disturbances of acid-base balance, especially with abnormalities of serum albumin and phosphate concentrations, the strong ion approach is recommended. With the understanding of both models and of the clinical presentation of blood gas abnormalities, optimal case management and therapy can be provided.

Schlüsselwörter

Säuren-Basen-Haushalt - Azidose - Alkalose - Strong Ion Approach - Henderson-Hasselbalch-Ansatz

Keywords

Acid-base state - acidosis - alkalosis - strong ion approach - HendersonHasselbalch approach

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