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Lowest Blood pH

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What is the lowest Blood pH you have ever seen drawn on a patient?

zambezi, BSN, RN

Specializes in CCU (Coronary Care); Clinical Research.

pH: 6.9 --> then 6.7 after 2 amps bicarb (needless to say, she passed on...)

Lowest pO2 I have seen is 33 (vent/100% FIo2/drawn from A-Line)

7.1 is the lowest I've ever seen. My pt also did not make it.

VivaLasViejas, ASN, RN

Specializes in LTC, assisted living, med-surg, psych. Has 20 years experience.

6.9. This patient did get through the initial crisis, but never made it out of the ICU. :o

NotReady4PrimeTime, RN

Specializes in NICU, PICU, PCVICU and peds oncology. Has 25 years experience.

6.73 on a teenager with sudden onset CNS collapse. He survived!!

Lowest pO2 I've seen is 27 on a neonate who went on ECMO and eventually died.

Highest pCO2 I've ever seen was 345 (ouch!) in a teenager with BOOP secondary to charcoal aspiration following Tylenol ingestion. She was conscious and c/o headache... Then she crumped. Got a double lung transplant, had multiple near-death experiences, slow recovery only to succumb to CMV pneumonia. Longest suicide I've ever seen.

talaxandra

Specializes in Medical.

I had a newly diagnosed IDDM come in with DKA - her pH was 7.01 and she was managed on the ward! She was unique in several ways - she was 50, was breast feeding her youngest child (aged four), and only had a BSL in the mid-tenties (our scale is different from yours - it's around 450 mg/dL). She had a really healthy diet to start with, which probably helped,a nd she didn't believe she was really that sick until I showed her her labs and told her she should have been in ICU. She survived :)

I have seen a pH of 6.9 and a pO2 of 18. These weren't in the same patient! Neither patient survived.

begalli

Specializes in Critical Care/ICU.

I know we've had those in the 6.something range but I have never personally seen this.

This is one of my favorite things to fix...a respiratory alk/acidosis. It's so rewarding after a couple of RN initiated vent changes.

pH of 6.8something. Suicide attempt by ingesting antifreeze. Surprisingly, the guy lived. I remember when the first gas came back and we heard the pH, one nurse said "is that even compatible with life?".

pH 6.7, pO2 17...trauma patient who did not make it. When I drew the gas, the trauma surgeon kept trying to tell me it was venous and no pO2 can be 17 (we had been basically coding this pt. for an hour). I reminded him that I drew the gas out of the art line that he inserted! He didn't say another word.

BittyBabyGrower, MSN, RN

Specializes in NICU, PICU, educator.

6.7-6.9 Pao2's in low 20's...and unfortunately some of those kids lived.

pricklypear

Specializes in Telemetry, ICU, Resource Pool, Dialysis. Has 11 years experience.

6.8-6.9

The 6.9 patient was found unresponsive at home. Gave her amp after amp of bicarb, and had bicarb in her fluids, pH never went up and she died about 6 hours after admission. Coags were super high. IMHO she ingested something (I think rat poison) to commit suicide. This was never proved. She was a "coroner's case" but was not autopsied at the family's request.

The other one was an abdominal postop who did poorly in PACU for too long, and was probably going septic since before surgery. I guess they found stool in her abdomen when they opened her up for surgery. She also died by 6am that morning with her pH never getting better than 7.1. Those were a couple of REALLY bad nights!!

6.9 on a diabetic ketoacidosis pt...survived.

I've never seen a pa02 less then 30 - 40 - I remember taking one somewhere in that range and concluding it must have been venous. Repeat taken. Um....no.

He had been putting alcohol down his peg.

I should be suprised, but I'm not. People try anything. I remember a mother once putting peas down her sons PEG tube....

Aneroo, LPN

Specializes in Cath Lab, OR, CPHN/SN, ER.

6.96- 2.2kg full term (so they said) brought into NICU after difficult delivery, possible meconium aspiration. Said when the team went in, they were doing compressions. Had a HR of 100 when he came back (4 epis? I think...). Don't remember specifics on rest of labs, but off the wall. Chemstrip registered at 9 and 13!!! Finally went back up to 60-ish after several D10 boluses.

-Andrea

-PS- I'm only a student. Was observing in NICU one week, so if I have some wrong values, forgive me! Just seemed WAY off to me.

Jessielee22

Specializes in ICU.

I had a pH of 7.14 last night pO2 of 46 through an A-line? Do you think he'll survive with those numbers?

NotReady4PrimeTime, RN

Specializes in NICU, PICU, PCVICU and peds oncology. Has 25 years experience.

The lowest I've ever seen was 6.72 in a child during E-CPR. We were successful in obtaining a return of circulation, but the patient ultimately died the next day. The lowest I've seen in a child who survived the ICU was 6.79, with a PO2 of 29 and a PCO2 of 141. This was also an E-CPR case, after which the child survived another 369 days but with severe sequelae; she actually just died last week.

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