Bloedgas analyse<\/title><\/p>\n<style>\n body {\n font-family: Arial, sans-serif;\n background: #fafafa;\n padding: 24px;\n color: #111;\n }\n .card {\n background: #fff;\n padding: 20px;\n border-radius: 8px;\n box-shadow: 0 2px 6px rgba(0,0,0,0.1);\n max-width: 900px;\n margin: auto;\n }\n h1 { font-size: 22px; margin-bottom: 16px; }\n label { display:block; margin-top:12px; font-weight:bold; }\n textarea, input[type=\"number\"] {\n width:100%;\n padding:8px;\n margin-top:6px;\n border:1px solid #ccc;\n border-radius:6px;\n box-sizing:border-box;\n font-size:14px;\n }\n textarea { min-height:180px; font-family: monospace; white-space: pre-wrap; }\n button {\n margin-top:14px;\n padding:10px 14px;\n border-radius:6px;\n border:none;\n background:#2d89ff;\n color:white;\n cursor:pointer;\n font-weight:600;\n }\n button:hover { background:#226ad6; }\n .result {\n margin-top:18px;\n padding:14px;\n border-radius:8px;\n background:#fff;\n border:1px solid #e6e6e6;\n }<\/p>\n<p> \/* table styling *\/\n table {\n width:100%;\n border-collapse:collapse;\n margin-top:10px;\n margin-bottom:14px;\n font-size:10px;\n font-family: Arial, sans-serif;\n }\n table td, table th {\n border:none;\n padding:2px 4px;\n vertical-align:top;\n }\n table th {\n background:none;\n text-align:left;\n font-weight:bold;\n }\n .labelcol { width:25%; font-weight:600; }\n .exprcol { width:35%; text-align:right; font-family: Consolas, monospace; white-space:nowrap; }\n .valuecol { width:40%; text-align:left; font-weight:700; }<\/p>\n<\/style>\n<p><\/head><br \/>\n<body><\/p>\n<div class=\"card\">\n<h1>Bloedgas analyse<\/h1>\n<form id=\"form\">\n\t\t<label for=\"bloedgas\">Plak hier het bloedgas in:<\/label><br \/>\n\t\t<textarea id=\"bloedgas\" placeholder=\"Plak hier het blok met bloedgasgegevens, helemaal tot aan lactaat\"><\/textarea><\/p>\n<p>\t\t<label for=\"albumine\">Albumine (g\/l):<\/label><br \/>\n\t\t<input id=\"albumine\" type=\"number\" step=\"any\" value=\"30\"><\/p>\n<p>\t\t<button type=\"button\" id=\"analyzeBtn\">Analyseer<\/button><br \/>\n\t<\/form>\n<div id=\"resultaat\" class=\"result\" style=\"display:none;\"><\/div>\n<\/p><\/div>\n\n<p><\/body><\/p>\n\n\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-7387b849 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<div data-wp-context=\"{ "autoclose": false, "accordionItems": [] }\" data-wp-interactive=\"core\/accordion\" role=\"group\" class=\"wp-block-accordion is-layout-flow wp-block-accordion-is-layout-flow\">\n<div data-wp-class--is-open=\"state.isOpen\" data-wp-context=\"{ "id": "accordion-item-1", "openByDefault": false }\" data-wp-init=\"callbacks.initAccordionItems\" data-wp-on-window--hashchange=\"callbacks.hashChange\" class=\"wp-block-accordion-item is-layout-flow wp-block-accordion-item-is-layout-flow\">\n<h3 class=\"wp-block-accordion-heading\"><button aria-expanded=\"false\" aria-controls=\"accordion-item-1-panel\" data-wp-bind--aria-expanded=\"state.isOpen\" data-wp-on--click=\"actions.toggle\" data-wp-on--keydown=\"actions.handleKeyDown\" id=\"accordion-item-1\" type=\"button\" class=\"wp-block-accordion-heading__toggle\"><span class=\"wp-block-accordion-heading__toggle-title\">Respiratoire acidose<\/span><span class=\"wp-block-accordion-heading__toggle-icon\" aria-hidden=\"true\">+<\/span><\/button><\/h3>\n\n\n\n<div inert aria-labelledby=\"accordion-item-1\" data-wp-bind--inert=\"!state.isOpen\" id=\"accordion-item-1-panel\" role=\"region\" class=\"wp-block-accordion-panel is-layout-flow wp-block-accordion-panel-is-layout-flow\">\n<ul class=\"wp-block-list\">\n<li>Alveolaire hypoventilatie<\/li>\n\n\n\n<li>Ademdepressie (sedativa, narcotica, OSAS, letsels ademhalingscentrum,overmatige O2 toediening bij chronische CO2 retentie)<\/li>\n\n\n\n<li>Neuromusculaire aandoeningen (spierziekten, fosfaatdepletie, neuropathie, myxoedeem, uitputting)<\/li>\n\n\n\n<li>Luchtwegobstructie (laryngospasme, bronchospasmen, corpus alienum)<\/li>\n\n\n\n<li>Aandoeningen van thoraxwand en diafragma (ribfracturen, kyphoscoliose, bovenbuikschirurgie)<\/li>\n\n\n\n<li>Toename CO2 productie bij stabiel adem minuut volume, zoals door rillen bij koorts, overvoeding, maligne hyperthermie, bic toediening<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<\/div>\n\n\n\n<div data-wp-context=\"{ "autoclose": false, "accordionItems": [] }\" data-wp-interactive=\"core\/accordion\" role=\"group\" class=\"wp-block-accordion is-layout-flow wp-block-accordion-is-layout-flow\">\n<div data-wp-class--is-open=\"state.isOpen\" data-wp-context=\"{ "id": "accordion-item-2", "openByDefault": false }\" data-wp-init=\"callbacks.initAccordionItems\" data-wp-on-window--hashchange=\"callbacks.hashChange\" class=\"wp-block-accordion-item is-layout-flow wp-block-accordion-item-is-layout-flow\">\n<h3 class=\"wp-block-accordion-heading\"><button aria-expanded=\"false\" aria-controls=\"accordion-item-2-panel\" data-wp-bind--aria-expanded=\"state.isOpen\" data-wp-on--click=\"actions.toggle\" data-wp-on--keydown=\"actions.handleKeyDown\" id=\"accordion-item-2\" type=\"button\" class=\"wp-block-accordion-heading__toggle\"><span class=\"wp-block-accordion-heading__toggle-title\">Respiratoire alkalose<\/span><span class=\"wp-block-accordion-heading__toggle-icon\" aria-hidden=\"true\">+<\/span><\/button><\/h3>\n\n\n\n<div inert aria-labelledby=\"accordion-item-2\" data-wp-bind--inert=\"!state.isOpen\" id=\"accordion-item-2-panel\" role=\"region\" class=\"wp-block-accordion-panel is-layout-flow wp-block-accordion-panel-is-layout-flow\">\n<ul class=\"wp-block-list\">\n<li>Alveolaire hyperventilatie<\/li>\n\n\n\n<li>CNS stimulatie (pijn, angst, koorts, zwangerschap, CNS aandoening (meningitis, tumor, CVA), hypoxemie, hyperthyreo\u00efdie, geneesmiddelen: salicylaten, progesteron, xanthines, analeptica, MDMA)<\/li>\n\n\n\n<li>Stimulatie thoraxreceptoren: hartfalen, longembolie<\/li>\n\n\n\n<li>Normalisatie CO2 productie na eerder hoger (bijv insult)<\/li>\n\n\n\n<li>Mechanische ventilatie<br>Leverfalen, sepsis<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">–> Behandel evt hypoMg\/K\/Po4 bij ernstige alkaloses<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<div data-wp-context=\"{ "autoclose": false, "accordionItems": [] }\" data-wp-interactive=\"core\/accordion\" role=\"group\" class=\"wp-block-accordion is-layout-flow wp-block-accordion-is-layout-flow\">\n<div data-wp-class--is-open=\"state.isOpen\" data-wp-context=\"{ "id": "accordion-item-3", "openByDefault": false }\" data-wp-init=\"callbacks.initAccordionItems\" data-wp-on-window--hashchange=\"callbacks.hashChange\" class=\"wp-block-accordion-item is-layout-flow wp-block-accordion-item-is-layout-flow\">\n<h3 class=\"wp-block-accordion-heading\"><button aria-expanded=\"false\" aria-controls=\"accordion-item-3-panel\" data-wp-bind--aria-expanded=\"state.isOpen\" data-wp-on--click=\"actions.toggle\" data-wp-on--keydown=\"actions.handleKeyDown\" id=\"accordion-item-3\" type=\"button\" class=\"wp-block-accordion-heading__toggle\"><span class=\"wp-block-accordion-heading__toggle-title\">Normal anion gap metabole acidose<\/span><span class=\"wp-block-accordion-heading__toggle-icon\" aria-hidden=\"true\">+<\/span><\/button><\/h3>\n\n\n\n<div inert aria-labelledby=\"accordion-item-3\" data-wp-bind--inert=\"!state.isOpen\" id=\"accordion-item-3-panel\" role=\"region\" class=\"wp-block-accordion-panel is-layout-flow wp-block-accordion-panel-is-layout-flow\">\n<p class=\"wp-block-paragraph\">–> Bepaal een urine strong ion difference (Na+K-Cl)<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Gastro-intestinale verliezen (dan urineSID <0)<\/li>\n\n\n\n<li>Hyperchloremie obv resuscitatie met NaCl (plasmalyte ook in mindere mate (dan urineSID <0))<\/li>\n\n\n\n<li>Renale tubulaire acidose (dan urineSID >0)\n<ul class=\"wp-block-list\">\n<li>Type I: distale RTA, urine pH >5.5<\/li>\n\n\n\n<li>Type II: proximale RTA, urine pH <5.5 en laag serum kalium<\/li>\n\n\n\n<li>Type IV: pH <5 en hoog serum kalium, aldosteron deficientie (ook gezien bij Addison’s)<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li>Hyperalimentatie (TPV, niet per se oraal)<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<\/div>\n\n\n\n<div data-wp-context=\"{ "autoclose": false, "accordionItems": [] }\" data-wp-interactive=\"core\/accordion\" role=\"group\" class=\"wp-block-accordion is-layout-flow wp-block-accordion-is-layout-flow\">\n<div data-wp-class--is-open=\"state.isOpen\" data-wp-context=\"{ "id": "accordion-item-4", "openByDefault": false }\" data-wp-init=\"callbacks.initAccordionItems\" data-wp-on-window--hashchange=\"callbacks.hashChange\" class=\"wp-block-accordion-item is-layout-flow wp-block-accordion-item-is-layout-flow\">\n<h3 class=\"wp-block-accordion-heading\"><button aria-expanded=\"false\" aria-controls=\"accordion-item-4-panel\" data-wp-bind--aria-expanded=\"state.isOpen\" data-wp-on--click=\"actions.toggle\" data-wp-on--keydown=\"actions.handleKeyDown\" id=\"accordion-item-4\" type=\"button\" class=\"wp-block-accordion-heading__toggle\"><span class=\"wp-block-accordion-heading__toggle-title\">Hoge anion gap metabole acidose<\/span><span class=\"wp-block-accordion-heading__toggle-icon\" aria-hidden=\"true\">+<\/span><\/button><\/h3>\n\n\n\n<div inert aria-labelledby=\"accordion-item-4\" data-wp-bind--inert=\"!state.isOpen\" id=\"accordion-item-4-panel\" role=\"region\" class=\"wp-block-accordion-panel is-layout-flow wp-block-accordion-panel-is-layout-flow\">\n<p class=\"wp-block-paragraph\">–> Bepaal de osmol gap:<br>gemeten osmolaliteit – (2 x [Na+] + [glucose] + [ureum])<br>>20 past, bij gemeten osmolaliteit >300, is indicatief voor toxische alcoholen<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>G<\/strong>lycolen (antivries\/oplosmiddelen van oa geneesmiddelen, medium-hoge osmol gap)<\/li>\n\n\n\n<li><strong>O<\/strong>xoproline (PCM\/fluclox, 10ml urine opsturen naar lab (EPIC “organische zuren (urine)” order))<\/li>\n\n\n\n<li><strong>L<\/strong>-lactaat\n<ul class=\"wp-block-list\">\n<li>type A = tgv weefsel hypoxie of anaerobe spieractiviteit<\/li>\n\n\n\n<li>type B = in afwezigheid van hypoxie, dus bijv bij inflammatie (witte bloedcel metabolisme, longen ttv resp insuff bij sepsis), minder klaring door minder leverflow, bij kanker, bij vit B1 en B6 defici\u00ebnties, bij ethanol icm medicatie (HIV medicatie, metformine, propofol, isoniazide, MDMA, citraat)<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>D<\/strong>-lactaat (alleen bij short bowel met bacteriele overgroei, moet als D-lactaat worden georderd)<\/li>\n\n\n\n<li><strong>M<\/strong>ethanol (hoge osmol gap, methanol spiegel EPIC order, behandel met bic\/actieve kool\/ethanol of fomepizol)<\/li>\n\n\n\n<li><strong>A<\/strong>spirine (weinig osmol gap, vaak eerst respiratoire alkalose door stimulatie ademcentrum, EPIC order “salicylzuur serum spiegel”, overweeg hemodialyse bij spiegel boven de 80\/coma\/AKI\/overvulling)<\/li>\n\n\n\n<li><strong>R<\/strong>enal failure (niet alleen ureum draagt bij, ook sulfaten, fosfaten)<\/li>\n\n\n\n<li><strong>K<\/strong>etonen (DM1, ethyl\/alcohol, vasten\/koolhydraatarm eten; op SEH POCT voor acetoacetaat)<\/li>\n<\/ul>\n<\/div>\n<\/div>\n\n\n\n<div data-wp-class--is-open=\"state.isOpen\" data-wp-context=\"{ "id": "accordion-item-5", "openByDefault": false }\" data-wp-init=\"callbacks.initAccordionItems\" data-wp-on-window--hashchange=\"callbacks.hashChange\" class=\"wp-block-accordion-item is-layout-flow wp-block-accordion-item-is-layout-flow\">\n<h3 class=\"wp-block-accordion-heading\"><button aria-expanded=\"false\" aria-controls=\"accordion-item-5-panel\" data-wp-bind--aria-expanded=\"state.isOpen\" data-wp-on--click=\"actions.toggle\" data-wp-on--keydown=\"actions.handleKeyDown\" id=\"accordion-item-5\" type=\"button\" class=\"wp-block-accordion-heading__toggle\"><span class=\"wp-block-accordion-heading__toggle-title\">Oorzaken verlaagde anion gap<\/span><span class=\"wp-block-accordion-heading__toggle-icon\" aria-hidden=\"true\">+<\/span><\/button><\/h3>\n\n\n\n<div inert aria-labelledby=\"accordion-item-5\" data-wp-bind--inert=\"!state.isOpen\" id=\"accordion-item-5-panel\" role=\"region\" class=\"wp-block-accordion-panel is-layout-flow wp-block-accordion-panel-is-layout-flow\">\n<ul class=\"wp-block-list\">\n<li>Hyponatriemie icm toename in andere ongemeten kationen (anders nl niet in balans), zoals:\n<ul class=\"wp-block-list\">\n<li>IgG bij multipel myeloom<\/li>\n\n\n\n<li>Hypermagnesiemie<\/li>\n\n\n\n<li>Hypercalciemie<\/li>\n\n\n\n<li>Lithium intoxicatie<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div>\n<\/div>\n\n\n\n<div data-wp-class--is-open=\"state.isOpen\" data-wp-context=\"{ "id": "accordion-item-6", "openByDefault": false }\" data-wp-init=\"callbacks.initAccordionItems\" data-wp-on-window--hashchange=\"callbacks.hashChange\" class=\"wp-block-accordion-item is-layout-flow wp-block-accordion-item-is-layout-flow\">\n<h3 class=\"wp-block-accordion-heading\"><button aria-expanded=\"false\" aria-controls=\"accordion-item-6-panel\" data-wp-bind--aria-expanded=\"state.isOpen\" data-wp-on--click=\"actions.toggle\" data-wp-on--keydown=\"actions.handleKeyDown\" id=\"accordion-item-6\" type=\"button\" class=\"wp-block-accordion-heading__toggle\"><span class=\"wp-block-accordion-heading__toggle-title\">Metabole alkalose<\/span><span class=\"wp-block-accordion-heading__toggle-icon\" aria-hidden=\"true\">+<\/span><\/button><\/h3>\n\n\n\n<div inert aria-labelledby=\"accordion-item-6\" data-wp-bind--inert=\"!state.isOpen\" id=\"accordion-item-6-panel\" role=\"region\" class=\"wp-block-accordion-panel is-layout-flow wp-block-accordion-panel-is-layout-flow\">\n<p class=\"wp-block-paragraph\">–> Bepaal urine chloride<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Chloor-responsieve metabole alkalose (urine chloride <10-20)<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Tekort aan vrij water (minder water = snellere stijging Na dan Cl)<\/li>\n\n\n\n<li>Verlies van meer Cl dan Na, bijv bij diuretica<\/li>\n\n\n\n<li>Herstel van hypercapnie (toen namelijk Cl verlies om te compenseren)<\/li>\n\n\n\n<li>Gastro-intestinaal verlies (braken, maagzuigdrainage)<\/li>\n\n\n\n<li>Toediening veel Na bijv door iv medicatie<\/li>\n\n\n\n<li>Tekort aan intracellulaire kationen (K, Mg) -> Indien overvuld, behandelen met KCl icm lisdiureticum, of MRA te geven zoals spiro (zijn ook Cl sparend).<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">–> Acetazolamide geven (geeft meer Na dan Cl uitscheiding, ook wat KCl uitscheiding)<br>–> Corrigeer kalium en magnesium<br>–> Overweeg zuurremming bij GE-verlies<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Chloor-resistente metabole alkalose (urine chloride >20)<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Hypokaliemie<\/li>\n\n\n\n<li>Basische stoffen toegevoegd (bv citraat CVVH, massale bloedtransfusie)<\/li>\n\n\n\n<li>Mineralocorticoid excess (M. Cushing, exogene stero\u00efden, ectopische ACTH productie, hyperaldosteronisme, Syndr van Bartter\/Gitelman)<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Kopieer het complete bloedgas (van Hb tot lactaat in de resultaten) in onderstaand veld. NB: werkt alleen voor het AMC. (en op dit moment helemaal nog niet omdat ik het script nog werkend moet krijgen binnen wordpress… komt binnenkort)<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-94","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/practicu.nl\/index.php?rest_route=\/wp\/v2\/pages\/94","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/practicu.nl\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/practicu.nl\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/practicu.nl\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/practicu.nl\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=94"}],"version-history":[{"count":11,"href":"https:\/\/practicu.nl\/index.php?rest_route=\/wp\/v2\/pages\/94\/revisions"}],"predecessor-version":[{"id":129,"href":"https:\/\/practicu.nl\/index.php?rest_route=\/wp\/v2\/pages\/94\/revisions\/129"}],"wp:attachment":[{"href":"https:\/\/practicu.nl\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=94"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}

{"id":94,"date":"2026-04-04T03:49:23","date_gmt":"2026-04-04T03:49:23","guid":{"rendered":"https:\/\/practicu.nl\/?page_id=94"},"modified":"2026-04-12T21:31:12","modified_gmt":"2026-04-12T21:31:12","slug":"bloedgas-analyse","status":"publish","type":"page","link":"https:\/\/practicu.nl\/?page_id=94","title":{"rendered":"Bloedgas analyse"},"content":{"rendered":"\n

Kopieer het complete bloedgas (van Hb tot lactaat in de resultaten) in onderstaand veld. NB: werkt alleen voor het AMC. (en op dit moment helemaal nog niet omdat ik het script nog werkend moet krijgen binnen wordpress… komt binnenkort)<\/p>\n\n\n

\n
\nBloedgas analyse<\/title><\/p>\n<style>\n body {\n font-family: Arial, sans-serif;\n background: #fafafa;\n padding: 24px;\n color: #111;\n }\n .card {\n background: #fff;\n padding: 20px;\n border-radius: 8px;\n box-shadow: 0 2px 6px rgba(0,0,0,0.1);\n max-width: 900px;\n margin: auto;\n }\n h1 { font-size: 22px; margin-bottom: 16px; }\n label { display:block; margin-top:12px; font-weight:bold; }\n textarea, input[type=\"number\"] {\n width:100%;\n padding:8px;\n margin-top:6px;\n border:1px solid #ccc;\n border-radius:6px;\n box-sizing:border-box;\n font-size:14px;\n }\n textarea { min-height:180px; font-family: monospace; white-space: pre-wrap; }\n button {\n margin-top:14px;\n padding:10px 14px;\n border-radius:6px;\n border:none;\n background:#2d89ff;\n color:white;\n cursor:pointer;\n font-weight:600;\n }\n button:hover { background:#226ad6; }\n .result {\n margin-top:18px;\n padding:14px;\n border-radius:8px;\n background:#fff;\n border:1px solid #e6e6e6;\n }<\/p>\n<p> \/* table styling *\/\n table {\n width:100%;\n border-collapse:collapse;\n margin-top:10px;\n margin-bottom:14px;\n font-size:10px;\n font-family: Arial, sans-serif;\n }\n table td, table th {\n border:none;\n padding:2px 4px;\n vertical-align:top;\n }\n table th {\n background:none;\n text-align:left;\n font-weight:bold;\n }\n .labelcol { width:25%; font-weight:600; }\n .exprcol { width:35%; text-align:right; font-family: Consolas, monospace; white-space:nowrap; }\n .valuecol { width:40%; text-align:left; font-weight:700; }<\/p>\n<\/style>\n<p><\/head><br \/>\n<body><\/p>\n<div class=\"card\">\n<h1>Bloedgas analyse<\/h1>\n<form id=\"form\">\n\t\t<label for=\"bloedgas\">Plak hier het bloedgas in:<\/label><br \/>\n\t\t<textarea id=\"bloedgas\" placeholder=\"Plak hier het blok met bloedgasgegevens, helemaal tot aan lactaat\"><\/textarea><\/p>\n<p>\t\t<label for=\"albumine\">Albumine (g\/l):<\/label><br \/>\n\t\t<input id=\"albumine\" type=\"number\" step=\"any\" value=\"30\"><\/p>\n<p>\t\t<button type=\"button\" id=\"analyzeBtn\">Analyseer<\/button><br \/>\n\t<\/form>\n<div id=\"resultaat\" class=\"result\" style=\"display:none;\"><\/div>\n<\/p><\/div>\n\n<p><\/body><\/p>\n\n\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-7387b849 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<div data-wp-context=\"{ "autoclose": false, "accordionItems": [] }\" data-wp-interactive=\"core\/accordion\" role=\"group\" class=\"wp-block-accordion is-layout-flow wp-block-accordion-is-layout-flow\">\n<div data-wp-class--is-open=\"state.isOpen\" data-wp-context=\"{ "id": "accordion-item-1", "openByDefault": false }\" data-wp-init=\"callbacks.initAccordionItems\" data-wp-on-window--hashchange=\"callbacks.hashChange\" class=\"wp-block-accordion-item is-layout-flow wp-block-accordion-item-is-layout-flow\">\n<h3 class=\"wp-block-accordion-heading\"><button aria-expanded=\"false\" aria-controls=\"accordion-item-1-panel\" data-wp-bind--aria-expanded=\"state.isOpen\" data-wp-on--click=\"actions.toggle\" data-wp-on--keydown=\"actions.handleKeyDown\" id=\"accordion-item-1\" type=\"button\" class=\"wp-block-accordion-heading__toggle\"><span class=\"wp-block-accordion-heading__toggle-title\">Respiratoire acidose<\/span><span class=\"wp-block-accordion-heading__toggle-icon\" aria-hidden=\"true\">+<\/span><\/button><\/h3>\n\n\n\n<div inert aria-labelledby=\"accordion-item-1\" data-wp-bind--inert=\"!state.isOpen\" id=\"accordion-item-1-panel\" role=\"region\" class=\"wp-block-accordion-panel is-layout-flow wp-block-accordion-panel-is-layout-flow\">\n<ul class=\"wp-block-list\">\n<li>Alveolaire hypoventilatie<\/li>\n\n\n\n<li>Ademdepressie (sedativa, narcotica, OSAS, letsels ademhalingscentrum,overmatige O2 toediening bij chronische CO2 retentie)<\/li>\n\n\n\n<li>Neuromusculaire aandoeningen (spierziekten, fosfaatdepletie, neuropathie, myxoedeem, uitputting)<\/li>\n\n\n\n<li>Luchtwegobstructie (laryngospasme, bronchospasmen, corpus alienum)<\/li>\n\n\n\n<li>Aandoeningen van thoraxwand en diafragma (ribfracturen, kyphoscoliose, bovenbuikschirurgie)<\/li>\n\n\n\n<li>Toename CO2 productie bij stabiel adem minuut volume, zoals door rillen bij koorts, overvoeding, maligne hyperthermie, bic toediening<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<\/div>\n\n\n\n<div data-wp-context=\"{ "autoclose": false, "accordionItems": [] }\" data-wp-interactive=\"core\/accordion\" role=\"group\" class=\"wp-block-accordion is-layout-flow wp-block-accordion-is-layout-flow\">\n<div data-wp-class--is-open=\"state.isOpen\" data-wp-context=\"{ "id": "accordion-item-2", "openByDefault": false }\" data-wp-init=\"callbacks.initAccordionItems\" data-wp-on-window--hashchange=\"callbacks.hashChange\" class=\"wp-block-accordion-item is-layout-flow wp-block-accordion-item-is-layout-flow\">\n<h3 class=\"wp-block-accordion-heading\"><button aria-expanded=\"false\" aria-controls=\"accordion-item-2-panel\" data-wp-bind--aria-expanded=\"state.isOpen\" data-wp-on--click=\"actions.toggle\" data-wp-on--keydown=\"actions.handleKeyDown\" id=\"accordion-item-2\" type=\"button\" class=\"wp-block-accordion-heading__toggle\"><span class=\"wp-block-accordion-heading__toggle-title\">Respiratoire alkalose<\/span><span class=\"wp-block-accordion-heading__toggle-icon\" aria-hidden=\"true\">+<\/span><\/button><\/h3>\n\n\n\n<div inert aria-labelledby=\"accordion-item-2\" data-wp-bind--inert=\"!state.isOpen\" id=\"accordion-item-2-panel\" role=\"region\" class=\"wp-block-accordion-panel is-layout-flow wp-block-accordion-panel-is-layout-flow\">\n<ul class=\"wp-block-list\">\n<li>Alveolaire hyperventilatie<\/li>\n\n\n\n<li>CNS stimulatie (pijn, angst, koorts, zwangerschap, CNS aandoening (meningitis, tumor, CVA), hypoxemie, hyperthyreo\u00efdie, geneesmiddelen: salicylaten, progesteron, xanthines, analeptica, MDMA)<\/li>\n\n\n\n<li>Stimulatie thoraxreceptoren: hartfalen, longembolie<\/li>\n\n\n\n<li>Normalisatie CO2 productie na eerder hoger (bijv insult)<\/li>\n\n\n\n<li>Mechanische ventilatie<br>Leverfalen, sepsis<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">–> Behandel evt hypoMg\/K\/Po4 bij ernstige alkaloses<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<div data-wp-context=\"{ "autoclose": false, "accordionItems": [] }\" data-wp-interactive=\"core\/accordion\" role=\"group\" class=\"wp-block-accordion is-layout-flow wp-block-accordion-is-layout-flow\">\n<div data-wp-class--is-open=\"state.isOpen\" data-wp-context=\"{ "id": "accordion-item-3", "openByDefault": false }\" data-wp-init=\"callbacks.initAccordionItems\" data-wp-on-window--hashchange=\"callbacks.hashChange\" class=\"wp-block-accordion-item is-layout-flow wp-block-accordion-item-is-layout-flow\">\n<h3 class=\"wp-block-accordion-heading\"><button aria-expanded=\"false\" aria-controls=\"accordion-item-3-panel\" data-wp-bind--aria-expanded=\"state.isOpen\" data-wp-on--click=\"actions.toggle\" data-wp-on--keydown=\"actions.handleKeyDown\" id=\"accordion-item-3\" type=\"button\" class=\"wp-block-accordion-heading__toggle\"><span class=\"wp-block-accordion-heading__toggle-title\">Normal anion gap metabole acidose<\/span><span class=\"wp-block-accordion-heading__toggle-icon\" aria-hidden=\"true\">+<\/span><\/button><\/h3>\n\n\n\n<div inert aria-labelledby=\"accordion-item-3\" data-wp-bind--inert=\"!state.isOpen\" id=\"accordion-item-3-panel\" role=\"region\" class=\"wp-block-accordion-panel is-layout-flow wp-block-accordion-panel-is-layout-flow\">\n<p class=\"wp-block-paragraph\">–> Bepaal een urine strong ion difference (Na+K-Cl)<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Gastro-intestinale verliezen (dan urineSID <0)<\/li>\n\n\n\n<li>Hyperchloremie obv resuscitatie met NaCl (plasmalyte ook in mindere mate (dan urineSID <0))<\/li>\n\n\n\n<li>Renale tubulaire acidose (dan urineSID >0)\n<ul class=\"wp-block-list\">\n<li>Type I: distale RTA, urine pH >5.5<\/li>\n\n\n\n<li>Type II: proximale RTA, urine pH <5.5 en laag serum kalium<\/li>\n\n\n\n<li>Type IV: pH <5 en hoog serum kalium, aldosteron deficientie (ook gezien bij Addison’s)<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li>Hyperalimentatie (TPV, niet per se oraal)<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<\/div>\n\n\n\n<div data-wp-context=\"{ "autoclose": false, "accordionItems": [] }\" data-wp-interactive=\"core\/accordion\" role=\"group\" class=\"wp-block-accordion is-layout-flow wp-block-accordion-is-layout-flow\">\n<div data-wp-class--is-open=\"state.isOpen\" data-wp-context=\"{ "id": "accordion-item-4", "openByDefault": false }\" data-wp-init=\"callbacks.initAccordionItems\" data-wp-on-window--hashchange=\"callbacks.hashChange\" class=\"wp-block-accordion-item is-layout-flow wp-block-accordion-item-is-layout-flow\">\n<h3 class=\"wp-block-accordion-heading\"><button aria-expanded=\"false\" aria-controls=\"accordion-item-4-panel\" data-wp-bind--aria-expanded=\"state.isOpen\" data-wp-on--click=\"actions.toggle\" data-wp-on--keydown=\"actions.handleKeyDown\" id=\"accordion-item-4\" type=\"button\" class=\"wp-block-accordion-heading__toggle\"><span class=\"wp-block-accordion-heading__toggle-title\">Hoge anion gap metabole acidose<\/span><span class=\"wp-block-accordion-heading__toggle-icon\" aria-hidden=\"true\">+<\/span><\/button><\/h3>\n\n\n\n<div inert aria-labelledby=\"accordion-item-4\" data-wp-bind--inert=\"!state.isOpen\" id=\"accordion-item-4-panel\" role=\"region\" class=\"wp-block-accordion-panel is-layout-flow wp-block-accordion-panel-is-layout-flow\">\n<p class=\"wp-block-paragraph\">–> Bepaal de osmol gap:<br>gemeten osmolaliteit – (2 x [Na+] + [glucose] + [ureum])<br>>20 past, bij gemeten osmolaliteit >300, is indicatief voor toxische alcoholen<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>G<\/strong>lycolen (antivries\/oplosmiddelen van oa geneesmiddelen, medium-hoge osmol gap)<\/li>\n\n\n\n<li><strong>O<\/strong>xoproline (PCM\/fluclox, 10ml urine opsturen naar lab (EPIC “organische zuren (urine)” order))<\/li>\n\n\n\n<li><strong>L<\/strong>-lactaat\n<ul class=\"wp-block-list\">\n<li>type A = tgv weefsel hypoxie of anaerobe spieractiviteit<\/li>\n\n\n\n<li>type B = in afwezigheid van hypoxie, dus bijv bij inflammatie (witte bloedcel metabolisme, longen ttv resp insuff bij sepsis), minder klaring door minder leverflow, bij kanker, bij vit B1 en B6 defici\u00ebnties, bij ethanol icm medicatie (HIV medicatie, metformine, propofol, isoniazide, MDMA, citraat)<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>D<\/strong>-lactaat (alleen bij short bowel met bacteriele overgroei, moet als D-lactaat worden georderd)<\/li>\n\n\n\n<li><strong>M<\/strong>ethanol (hoge osmol gap, methanol spiegel EPIC order, behandel met bic\/actieve kool\/ethanol of fomepizol)<\/li>\n\n\n\n<li><strong>A<\/strong>spirine (weinig osmol gap, vaak eerst respiratoire alkalose door stimulatie ademcentrum, EPIC order “salicylzuur serum spiegel”, overweeg hemodialyse bij spiegel boven de 80\/coma\/AKI\/overvulling)<\/li>\n\n\n\n<li><strong>R<\/strong>enal failure (niet alleen ureum draagt bij, ook sulfaten, fosfaten)<\/li>\n\n\n\n<li><strong>K<\/strong>etonen (DM1, ethyl\/alcohol, vasten\/koolhydraatarm eten; op SEH POCT voor acetoacetaat)<\/li>\n<\/ul>\n<\/div>\n<\/div>\n\n\n\n<div data-wp-class--is-open=\"state.isOpen\" data-wp-context=\"{ "id": "accordion-item-5", "openByDefault": false }\" data-wp-init=\"callbacks.initAccordionItems\" data-wp-on-window--hashchange=\"callbacks.hashChange\" class=\"wp-block-accordion-item is-layout-flow wp-block-accordion-item-is-layout-flow\">\n<h3 class=\"wp-block-accordion-heading\"><button aria-expanded=\"false\" aria-controls=\"accordion-item-5-panel\" data-wp-bind--aria-expanded=\"state.isOpen\" data-wp-on--click=\"actions.toggle\" data-wp-on--keydown=\"actions.handleKeyDown\" id=\"accordion-item-5\" type=\"button\" class=\"wp-block-accordion-heading__toggle\"><span class=\"wp-block-accordion-heading__toggle-title\">Oorzaken verlaagde anion gap<\/span><span class=\"wp-block-accordion-heading__toggle-icon\" aria-hidden=\"true\">+<\/span><\/button><\/h3>\n\n\n\n<div inert aria-labelledby=\"accordion-item-5\" data-wp-bind--inert=\"!state.isOpen\" id=\"accordion-item-5-panel\" role=\"region\" class=\"wp-block-accordion-panel is-layout-flow wp-block-accordion-panel-is-layout-flow\">\n<ul class=\"wp-block-list\">\n<li>Hyponatriemie icm toename in andere ongemeten kationen (anders nl niet in balans), zoals:\n<ul class=\"wp-block-list\">\n<li>IgG bij multipel myeloom<\/li>\n\n\n\n<li>Hypermagnesiemie<\/li>\n\n\n\n<li>Hypercalciemie<\/li>\n\n\n\n<li>Lithium intoxicatie<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div>\n<\/div>\n\n\n\n<div data-wp-class--is-open=\"state.isOpen\" data-wp-context=\"{ "id": "accordion-item-6", "openByDefault": false }\" data-wp-init=\"callbacks.initAccordionItems\" data-wp-on-window--hashchange=\"callbacks.hashChange\" class=\"wp-block-accordion-item is-layout-flow wp-block-accordion-item-is-layout-flow\">\n<h3 class=\"wp-block-accordion-heading\"><button aria-expanded=\"false\" aria-controls=\"accordion-item-6-panel\" data-wp-bind--aria-expanded=\"state.isOpen\" data-wp-on--click=\"actions.toggle\" data-wp-on--keydown=\"actions.handleKeyDown\" id=\"accordion-item-6\" type=\"button\" class=\"wp-block-accordion-heading__toggle\"><span class=\"wp-block-accordion-heading__toggle-title\">Metabole alkalose<\/span><span class=\"wp-block-accordion-heading__toggle-icon\" aria-hidden=\"true\">+<\/span><\/button><\/h3>\n\n\n\n<div inert aria-labelledby=\"accordion-item-6\" data-wp-bind--inert=\"!state.isOpen\" id=\"accordion-item-6-panel\" role=\"region\" class=\"wp-block-accordion-panel is-layout-flow wp-block-accordion-panel-is-layout-flow\">\n<p class=\"wp-block-paragraph\">–> Bepaal urine chloride<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Chloor-responsieve metabole alkalose (urine chloride <10-20)<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Tekort aan vrij water (minder water = snellere stijging Na dan Cl)<\/li>\n\n\n\n<li>Verlies van meer Cl dan Na, bijv bij diuretica<\/li>\n\n\n\n<li>Herstel van hypercapnie (toen namelijk Cl verlies om te compenseren)<\/li>\n\n\n\n<li>Gastro-intestinaal verlies (braken, maagzuigdrainage)<\/li>\n\n\n\n<li>Toediening veel Na bijv door iv medicatie<\/li>\n\n\n\n<li>Tekort aan intracellulaire kationen (K, Mg) -> Indien overvuld, behandelen met KCl icm lisdiureticum, of MRA te geven zoals spiro (zijn ook Cl sparend).<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">–> Acetazolamide geven (geeft meer Na dan Cl uitscheiding, ook wat KCl uitscheiding)<br>–> Corrigeer kalium en magnesium<br>–> Overweeg zuurremming bij GE-verlies<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Chloor-resistente metabole alkalose (urine chloride >20)<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Hypokaliemie<\/li>\n\n\n\n<li>Basische stoffen toegevoegd (bv citraat CVVH, massale bloedtransfusie)<\/li>\n\n\n\n<li>Mineralocorticoid excess (M. Cushing, exogene stero\u00efden, ectopische ACTH productie, hyperaldosteronisme, Syndr van Bartter\/Gitelman)<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Kopieer het complete bloedgas (van Hb tot lactaat in de resultaten) in onderstaand veld. NB: werkt alleen voor het AMC. (en op dit moment helemaal nog niet omdat ik het script nog werkend moet krijgen binnen wordpress… komt binnenkort)<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-94","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/practicu.nl\/index.php?rest_route=\/wp\/v2\/pages\/94","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/practicu.nl\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/practicu.nl\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/practicu.nl\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/practicu.nl\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=94"}],"version-history":[{"count":11,"href":"https:\/\/practicu.nl\/index.php?rest_route=\/wp\/v2\/pages\/94\/revisions"}],"predecessor-version":[{"id":129,"href":"https:\/\/practicu.nl\/index.php?rest_route=\/wp\/v2\/pages\/94\/revisions\/129"}],"wp:attachment":[{"href":"https:\/\/practicu.nl\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=94"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}