ABG's

[apromm]

I was wondering if someone could me interpret this... Ph 7.47, Co2 35, HCo3 25, O2 142. Thanks...

[Daytonite, BSN, RN]

Compensated Respiratory Alkalosis

[apromm]

Even though the pH is the only abnomal? pH is alkalotic, and bicarb and Co2 are both normal but on the alkalotic side... I'm not quite sure I understand this.

[Daytonite, BSN, RN]

It's alkalosis, but the CO2 is on the high end of normal, therefore, it is still compensated. If you feel better, call it straight out respiratory alkalosis because that is where it is headed.

[hypocaffeinemia, BSN, RN]

Anything more about the patient? Are they on a vent?

[apromm]

Yes, the patient is on a vent...

[hypocaffeinemia, BSN, RN]

Yes, the patient is on a vent...

That's what I expected based on the pO2.

In this case, it isn't compensated respiratory alkalosis. More like induced respiratory alkalosis. I often see a mild alkalosis in vented patients. The combination of actual good tidal volumes and decent rate leads to increased removal of CO2 and this is reflected by the pCO2 of 35.

This can be corrected, with collaboration from the intensivist and respiratory therapist, best by lowering the rate of ventilation. Or, if the patient is spontaneously breathing above the vent rate in AC mode, considering SIMV mode.

[tlc2u]

i was wondering if someone could me interpret this... ph 7.47, co2 35, hco3 25, o2 142. thanks...

ph - 7.47 = alkalosis (uncompensated - compensation is determined by the ph. to be compensated the ph would be within normal range of 7.35-7.45)

co2 - 35 = (alkaline - co2 of

(normal co2 = 35-45)

hco3 - 25 = (alkaline side of normal)

(normal bicarb - hco3 = 22-26)

o2 142 = (increased oxygen levels with patient on a vent)

above is my interpretation of this if i was to give this a label i would have to say uncompensated respiratory alkalosis or uncompensated mixed respiratory and metabolic alkalosis. this may not be the label expected on a test question as the co2 and hco3 are only on the alkaline side of normal.

as hypocaffeinemia stated more like induced respiratory alkalosis. i often see a mild alkalosis in vented patients. the combination of actual good tidal volumes and decent rate leads to increased removal of co2 and this is reflected by the pco2 of 35. that would explain the co2 on the alkaline side of normal.

if the patient is on a vent and being treated for stress ulcers this could explain the hco3 being on the alkaline side of normal.

http://www.nursingcenter.com/prodev/ce_article.asp?tid=933671

mechanical ventilation may cause physiologic effects in other body systems as well. in the gastrointestinal system, a stress ulcer (stress-related erosive syndrome, or sres) can occur within a few days of being intubated and ventilated, so appropriate steps should be taken to protect the gut. sres occurs because of increased ph that leads to ulcerations and hemorrhage.

websites for abg interpretations

http://www.ekgusa.com/ceol/abgmap/abgindex.html

http://realnurseed.com/abgm4.htm

hope this helps.