1/ #UncleBob presents his analysis of the ABG -
on 2L
pH 7.3
pCO2 78
pO2 84
calc HCO3 33
We cannot accurately assess the A-a gradient with nasal oxygen. There may be an increased A-a gradient, but I doubt enough to explain the dyspnea.
on 2L
pH 7.3
pCO2 78
pO2 84
calc HCO3 33
We cannot accurately assess the A-a gradient with nasal oxygen. There may be an increased A-a gradient, but I doubt enough to explain the dyspnea.
https://twitter.com/medrants/status/1160530765966389248
2/
The patient has an acute on chronic respiratory acidosis. I suspect that his hypoventilation became acutely worse after nasal oxygen. Thus, his pCO2 likely increased over his baseline. I assume the calc bicarb (very similar to measured) supports chronic hypoventilation.
The patient has an acute on chronic respiratory acidosis. I suspect that his hypoventilation became acutely worse after nasal oxygen. Thus, his pCO2 likely increased over his baseline. I assume the calc bicarb (very similar to measured) supports chronic hypoventilation.
3/
If we have no evidence of primary or secondary lung disease, the best explanation would be muscular weakness. In fact further evaluation showed a neuromuscular disease.
Please critique this analysis in case I have made inaccurate assumptions.
If we have no evidence of primary or secondary lung disease, the best explanation would be muscular weakness. In fact further evaluation showed a neuromuscular disease.
Please critique this analysis in case I have made inaccurate assumptions.
4/
This is a preview of my talk at Midwest #HospitalMedicine Conference at Northwestern, Oct 24-26 . Registration/agenda at midwesthospitalmedicine.com
Hope to see many of you there.
This is a preview of my talk at Midwest #HospitalMedicine Conference at Northwestern, Oct 24-26 . Registration/agenda at midwesthospitalmedicine.com
Hope to see many of you there.
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