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Hinniegram
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The Hinniegram is designed to aid medical doctors in the interpretation of blood gas results. Many doctors find blood gas result interpretation difficult and the Hinniegram helps to simplify this process. The aim is to establish the patients acid/base status quickly using blood gas results. The beauty of the Hinniegram is that it can be constructed any time/any where simply by recalling one fact. The user has to remember whether CO<sub>2</sub> goes up or down in one of the four possible acid/base categories. These are Respiratory Acidosis, Respiratory Alkalosis, Metabolic Acidosis and Metabolic Alkalosis. The easiest of these to remember is probably Respiratory Acidosis where the lungs are not working well and CO<sub>2</sub> is therefore not got rid of. In Respiratory Acidosis CO<sub>2</sub> therefore goes up. The Hinniegram consists of a 2 x 2 table. 2 columns marked Respiratoty and Metabolic and 2 rows marked Acidosis and Alkalosis. In the table the user places his one remembered fact e.g. CO<sub>2</sub> goes up in respiratory acidosis. Respiratory Metabolic Acidosis CO<sub>2</sub> up Alkalosis The rest of the Hinniegram is completed by remembering that CO<sub>2</sub> in any of the four categories goes in the opposite direction to the category in the box next to it or below it. Respiratory Metabolic Acidosis CO<sub>2</sub> up CO<sub>2</sub> down Alkalosis CO<sub>2</sub> down CO<sub>2</sub> up The Hinniegram can now be used to iterpret blood gas results. The first step in this process is to look at the hydrogen ion concentration. The reference range is 35-45 nmol/l. Below 35 means the patient is alkalotic and above 45 means the patient is acidotic. The next step is to look at CO<sub>2</sub> concentration. Lets suppose it goes down as in the following example of blood gas results. H+ 22 nmol/l, PCO<sub>2</sub> 2.1 kPa, PO<sub>2</sub> 11.7 kPa, HCO<sub>3</sub> 17 mmol/l Step 1. Look at the hydrogen ion concentration - this is an Alkalosis Step 2. Look at the CO<sub>2</sub> - this is down (reference range 4.6 - 6.0) Step 3. Look in the Alkalosis row of the Hinniegram for the box with CO<sub>2</sub> down in it. In this example you therefore have a Respratory Alkalosis. See Also
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