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Discussion

ABG question

i have a patient tomorrow who is in metabolic alkalosis. on her ABGs, she has a pO2 of 527. she does have COPD with scarring and atelectasis, but is it just me or is that out of control high? is there anything that would be done about that or is it just something that can't be changed? i feel super confused about this number.

also her prealbumin is 9.0 which is obviously low, but is that going to be considered severe malnutrition or not?

can anyone help?

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under what circumstances was the abg done, was the patient being hyperoxygenating for a particular reason, how much o2 was the patient on when taking, really need more info. Usually that high of a po2 is seen during 100% bagging of a patient. But cant say for sure.

Your pO2 could be this high, as the previous poster noted due to hyperoxgenation (bagging, extra breaths before suctioning...), but usually you're going to see the pO2 to be about 3x the FiO2. Or at least in that ballpark. Now, a high pO2 may be contributing to the alkalosis if it is due to increasing respirations due to blowing off CO2, but most times your pO2 isn't going to play in to you ABG. But again, liked noted above, it is to hard to make an informed analysis just based on the pO2 reading.

As for the prealbumin, I can't remember what constitutes severe malnutrition, but that may be the case.

Tom

  • Experts

Here is a link to information about the prealbumin test:

http://www.labtestsonline.org/understanding/analytes/prealbumin/test.html

Use of prealbumin as a measure of malnutrition is questionable since it fluctuates rapidly in one's system. I have mostly seen it used to monitor the effectiveness of TPN. Steroidal use and concurrent infection or inflammation (as in COPDers) can cause false low readings of this test. It is much better to look at other indicators of malnutrition as well rather than rely on this one test to diagnose malnutrition. Something else to consider here is possible liver damage. Was this patient having anasarca (whole body edema)?

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