32 year old asthmatic lady presented to the emergency department with shortness of breath for few days. Her venous blood gases showed the following:
PH = 7.53
pCO2 = 25 mmHg
32 year old asthmatic lady presented to the emergency department with shortness of breath for few days. Her venous blood gases showed the following:
PH = 7.53
pCO2 = 25 mmHg
Answers:
Question 1:
PH = 7.12, that is moderate to severe acidaemia.
HCO3 = 7 mmol/L. So, we have metabolic acidosis.
56 year old man with background of type 2 DM. Presented after a fall at home. He was presyncopal with blood pressure of 60/50 and pulse rate of 50/ min. (Normal sinus rhythm).
His Arterial blood gases (on 3L Oxygen)showed the following:
PH = 7.12
Answers:
PH = 7.56, that is moderate alkalaemia
HCO3 = 38.4 mmol/L, so we have metabolic alkalosis.
Next, we will calculate the compensation. For metabolic alkalosis we use the following equation:
An alcoholic man presented to the emergency department after suffering from a seizure. His venous blood gases showed the following:
PH = 7.56
pCO2 = 42 mmHg
Answers:
PH = 7.30, that is mild acidaemia.
pCO2 = 65 mmHg. So, we have respiratory acidosis.
Next, we need to look at the compensation. Compensation for respiratory acidosis is different between acute and chronic cases.
60 year-year-old man with history of DM and x-smoker but not known to have COPD. Presented to an emergency department with shortness of breath. His blood gases showed the following:
PH = 7.30
pCO2 = 65 mmHg
PH = 7.395, that is within normal range.
pCO2 = 42 mmHg, Normal for venous blood gases ( Normal pCO2 is 40 mmHg for arterial blood and 48 mmHg for venous).
HCO3 = 25 mmol/L. that is very slightly above the normal (normal level is 24)
25 year-old-man with type 1 DM presented with diarrhoea and vomiting. His VBG showed the following:
PH = 7.395
pCO2 = 42 mmHg
pO2 = 54 mmHg
PH = 7.745, that is severe alkalaemia.
pCO2 = 36 mmHg is low so we have respiratory alkalosis. However this value is very close to normal value of 40. This won’t explain the severely elevated PH.