Case 3 A three year old child was brought into the hospital with a cough, respir

Question

Case 3 A three year old child was brought into the hospital with a cough, respiratory distress, an cyanosis. Physical examination suggested a lower respiratory tract infection. A throat swab was positive for Staphylococcus. On admission, arteriole Poz was 29 mm Hg, Pcoz 75 mm Hg, HCO3 32 mmol/L, and pH 7.24. What type of acid/base disturbance is present? After 48 hours of treatment in the hospital (humidified air to breathe, antibiotics), arteriole Pco2 was 53 mm Hg, the HCO3 dropped to 31 mmol/L, and pH was 7.39. Explain to me why the plasma bicarbonate hardly changed, despite the 22 mm Hg drop in Pco2. CO2

Explanation / Answer

Question 1

Answer is Compensated Respiratory acidosis.

The increased level of plasma carbon dioxide levels. the normal values of Pco2, Po2, HCO3 and pH as follows

pH - 7.35 - 7.45

PaCO2 - 35 - 45 mm Hg

pO2 - 80 - 95 mm Hg

HCO3 - 22 - 26 mEq/L.

respiratory acidosis

Respiratory acidosis

pH

Pa CO2

HCO3

Acute

< 7.35

>45

Normal

Partly compensated

< 7.35

>45

>26

compensated

Normal

>45

>26

Question 2

The above condition is caused by increased Pco2 level so we must reduce these levels. the treatment must bring the Pco2 levels to normal that is 35 - 45 mm Hg. then the condition is treated. so the drop in Pco2 from 75 mmHg to 53 mmHg.

Respiratory acidosis

pH

Pa CO2

HCO3

Acute

< 7.35

>45

Normal

Partly compensated

< 7.35

>45

>26

compensated

Normal

>45

>26

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