Ph 7.25 And Pco2 60
Arterial Blood Gas
Case 5 Answers
A 68 year-old homo with a history of very severe COPD (FEV1 ~ 1.0L, <25% predicted) and chronic carbon dioxide retentiveness (Baseline PCO2 58) presents to the emergency room complaining of worsening dyspnea and an increment in the frequency and purulence of his sputum production over the by two days. His oxygen saturation is 78% on room air. Before he is place on supplemental oxygen, a room air arterial claret gas is fatigued and reveals: pH vii.25, PCOii 68, PO2 48, HCOiii- 31
Acid-base condition:
- The patient has a low pH (acidemia)
- The patient has a loftier PCO2 (respiratory acidosis) and a loftier bicarbonate (metabolic alkalosis). The combination of the low pH and the loftier PCO2 tells united states of america that the respiratory acidosis is the principal procedure.
- The metabolic alkalosis is the compensatory process. The pH is withal low despite this metabolic compensation
- Summary: Primary respiratory acidosis with compensatory metabolic alkalosis.
Alveolar-arterial oxygen deviation:
The alveolar-arterial oxygen difference is 17 mmHg. This value is elevated, suggesting that the hypoxemia is due to either shunt or areas of low V/Q (the more likely explanation in a patient with COPD) and cannot be explained past hypoventilation alone.
Explanation for the clinical picture:
The patient has very astringent COPD and chronic carbon dioxide retention. As a result, you look that at baseline, they will take a chronic respiratory acidosis (his baseline PCO2 was 58) with a compensatory metabolic alkalosis. In this case, the clinical history suggests the patient is in an exacerbation. When the patient presents to the ER, his PCO2 is elevated above his baseline. Because this is an astute change, the bicarbonate has not had time to adapt and the pH falls. This instance is, therefore, an example of an astute on chronic respiratory acidosis.
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Ph 7.25 And Pco2 60,
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