80 year old man presented with shortness of breath. This patient had history of CHF and COPD. His venous blood gases showed the following
- PH = 7.409
- pCO2 = 54 mmHg
80 year old man presented with shortness of breath. This patient had history of CHF and COPD. His venous blood gases showed the following
PH = 7.39, that is within the normal range.
pCO2 = 30 mmHg, that is slightly low. This patient might have respiratory alkalosis.
Next, we should look at the compensation for respiratory acidosis. (This patient is 2 years old. The condition will be acute).
2-year-old boy brought to ED by ambulance as category 1 for severe croup. His blood gases showed the following.
PH = 7.39
PH = 6.782, that is severe acidaemia.
HCO3 = 2.5 mmol/L, that is extremely low. So we have metabolic acidosis.
Next we need to calculate the compensation and find out what type of metabolic acidosis this patient has.
72 year-year-old man with history of type II DM and has a single kidney. Presented with 2 weeks of diarrhoea. He has been in bed for 2 weeks. Unresponsive. Last proper meal was 2 weeks ago. His Venous blood gases showed the following:
PH = 6.782
pCO2 = 17 mmHg
pO2 = 75 mmHg
Question 1:
PH = 7.30, that is mild acidaemia.
HCO3 = 18, that is low (less than 24), So we have metabolic acidosis.
Once we have metabolic acidosis, next step is to calculate compensation and anion gap.
17-year-old boy with wrist fracture. This patient became blue during manipulation of the fracture under bier’s block anaesthetic effect.
Arterial blood gas was performed and it showed the following:
PH = 7.30
PCO2 = 28 mmHg
This VBG was from a young girl with sever gastroenteritis (Vomiting and diarrhoea) for 3 days.
PH = 7.52, that is moderate alkalaemia.
pCO2 = 21 mmHg. So, we have respiratory alkalosis.
Question 1:
PH = 7.299 that is moderate acidaemia (less than 7.3), however we can argue that is mild as it is just 0.001 less than the value for mild acidaemia – ultimately, it is not going to change the management for the patient.
pCO2 = 52 mmHg, so we have respiratory acidosis.