Blood Gas

What is your interpretation of the blood gas?

a. Respiratory acidosis
b. Respiratory alkalosis
c. Metabolic alkalosis
d. Metabolic acidosis


What is the reason and how do you want to treat that?

Any changes on the ventilator settings?

Metabolic Acidosis.

The reason is due to hypoperfusion. When there is hypoperfusion, lactic acid production occurs, anaerobic metabolism ensues and that results into metabolic acidosis.

No changes on the ventilator settings. Give sodium bicarbonate as a temporary fix, treat the hypoperfusion as far as the definitive treatment.

Additional information:

What is the patient's Anion Gap?

The Anion Gap is 21. How did we do that? Add sodium and potasium, minus chloride and CO2.

An Anion gap of less than 15 is normal - that means the metabolic acidosis is due to a base loss.

An anion gap of greater than 15 means that the metabolic acidosis is an acid gain. In this case the hypoperfusion causing lactic acidosis is an acid gain.

Here is another DYK (Did You Know)

Anion gap is not useful when the patient is not on metabolic acidosis!!!

ABG
ph - 7.30
pCO2 - 40
HCO3 - 18
Base Excess - -4

Happy reading!!!