Questions: Interpret the following ABG: pH 6.88 PaCO 229 PaO 283 HCO 38

To interpret the given arterial blood gas (ABG) values, we need to analyze each component and understand what they indicate about the patient's acid-base status and respiratory function.

1. pH = 6.88:

   • A normal pH range is typically 7.35 to 7.45. A pH of 6.88 indicates severe acidemia, meaning the blood is much more acidic than normal.

2. PaCO₂ = 229 mmHg:

   • The normal range for PaCO₂ (partial pressure of carbon dioxide) is 35-45 mmHg. A PaCO₂ of 229 mmHg is extremely elevated, suggesting severe respiratory acidosis due to hypoventilation or an inability to expel CO₂ effectively.

3. PaO₂ = 283 mmHg:

   • The normal range for PaO₂ (partial pressure of oxygen) is 75-100 mmHg. A PaO₂ of 283 mmHg is abnormally high, which could indicate supplemental oxygen use or hyperoxia.

4. HCO₃⁻ = 38 mEq/L:

   • The normal range for bicarbonate (HCO₃⁻) is 22-26 mEq/L. A value of 38 mEq/L is elevated, suggesting a compensatory metabolic alkalosis in response to the respiratory acidosis.

Interpretation:

• The primary disturbance is a severe respiratory acidosis, as indicated by the extremely high PaCO₂ and low pH.
• The elevated HCO₃⁻ suggests a compensatory metabolic alkalosis, where the kidneys are retaining bicarbonate to buffer the excess acid.
• The high PaO₂ could be due to the administration of supplemental oxygen, which is common in patients with respiratory failure.

Summary: The ABG indicates a primary severe respiratory acidosis with compensatory metabolic alkalosis. The patient is likely experiencing significant respiratory failure, possibly requiring mechanical ventilation and careful monitoring of oxygen therapy.