Respiratory Failure Abg Examples

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Interpretation of arterial blood gases abgs david a. Chronic compensated respiratory acidosis with hypoxemic respiratory failure.

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They should always be interpreted as part of a wider assessment of a patient s respiratory function and in line with your organisation s policies.

Respiratory failure abg examples. Kaufman md chief section of pulmonary critical care sleep medicine bridgeport hospital yale new haven health assistant clinical professor yale university school of medicine section of pulmonary critical care medicine introduction. As the measured paco2 is 56 mmhg above the normal value 40 mmhg the expected hco3 is the normal value 24 mmol l 4 x 5 6 46 4 mmol l. The volume of air flowing in and out of the lungs is not matched with the flow of blood to the lung tissue.

These may all further develop into type 2 respiratory failure. As a result of the vq mismatch pao 2 falls and paco 2 rises. This is a respiratory acidosis.

The pao 2 is low so we know the patient is in respiratory failure however we don t yet know what type. You are called to see a 54 year old lady on the ward. For the example 65 year old patient with a history of coad and ccf presents to your department complaining of difficulty breathing the answer changes from 5 to 20 as 0 4 x 713 285.

Abgs should be thought of as a snapshot of how the body is interacting with its environment at a particular time. For example respiratory failure from scoliosis may require surgical correction of the spine to enable the lungs and heart. Abg examples abg exam questions for medical students osces and mrcp paces below are some brief clinical scenarios with abg results.

Hyperglycaemic states associated with diabetes mellitus. Try to interpret each abg and formulate a differential diagnosis before looking at the answer. It occurs as a result of ventilation perfusion v q mismatch.

Any severe illness which may lead to a metabolic acidosis for example. Interpreting an arterial blood gas abg is a crucial skill for physicians nurses respiratory. This abg is an example of a partially compensated respiratory acidosis.

Expected hco3 if chronic compensated respiratory acidosis is a hco3 rise of 4 mmol l for every 10 mmhg increase in paco2. Examples of causes of type 1 respiratory failure are pulmonary embolus reduced perfusion pulmonary fibrosis pneumonia asthma copd and pulmonary oedema reduced ventilation. Type 2 respiratory failure involves hypoxia p a o 2 8 kp a with hypercapnia p a co 2 6 0 kp a.

Type 1 respiratory failure involves hypoxaemia pao 2 8 kpa with normocapnia paco 2 6 0 kpa. Respiratory failure in acute and chronic states. In this case the paco 2 is raised significantly and this is likely to be the cause of the acidosis.

You should then note that the ph reveals an acidosis and assess the co 2 to see if it is contributing to the acidosis co 2. Treatments for acute respiratory failure depend on the underlying cause.

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