80-year-old lady presented with confusion. Her Venous blood gases showed the following:
PH = 7.396
pCO2 = 52 mmHg
80-year-old lady presented with confusion. Her Venous blood gases showed the following:
PH = 7.396
pCO2 = 52 mmHg
Question 1:
PH = 7.30 that is mild acidaemia.
HCO3 = 16 mmol/L (>24) so we have metabolic acidosis.
Next, we need to calculate the anion gap and the compensation (using Winter’s formula)
61-year-old man presented to ED with hypoglycemia that was difficult to correct with oral and IV dextrose. His venous blood gases showed the following.
PH = 7.30
PCO2 = 33 mmol/L
Answers:
PH = 7.39, that is within normal range/
pCO2 = 48 mmHg, that is slightly elevated (Can be considered normal for venous blood)
HCO3 = 29 mmol/L. That is high (Normal value is 24 mmol/L), SO, we have metabolic alkalosis.
80 year old lady with type 2 DM was referred for high blood sugar. Her blood gases showed the following:
PH = 7.39
pCO2 = 48 mmol/L
Answers:
PH = 7.34, that is very mild acidaemia.
HCO3 = 14 mmol/L. So, we have metabolic acidosis.
Next we need to calculate Anion Gap and compensation.
A police recruit doing a 20 km pack hike. Collapsed. GCS on arrival was 7. His temperature was 39.2 on arrival. His venous blood gases showed the following:
PH = 7.34
pCO2 = 27 mmHg
Answers:
PH = 7.391, that is within the normal range, slightly to the acidic side.
pCO2 = 57 mmHg, that is high. So we have respiratory acidosis.
It is not clear from the history if the condition is acute or chronic. Accordingly we are going to check for both.
58-year-old lady with history of obstructive sleep apnoea presented with Syncope. Her venous blood gases showed the following:
PH = 7.391
pCO2 = 57 mmHg
Answers
PH = 7.507, that is alkalaemia
pCO2 = 28 mmHg. So, we have respiratory alkalosis.