ABG q's

[PinchandBurn]

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Doing some questions last minute here:

Does someone with Idiopathic Pulm fibrosis have any special ABG derangements? (like how COPDers retain CO2). I'm assuming their O2 on RA is slightly low, but their pH should really be normal (since it's chronic and compensated). CO2 should be normal.

Whywould a young guy that lives at sealevel, ater having gone hiking at 14,000 feet have a ABG of: 7.55 pH, CO2 of 24, O2 of 57? My take. The pO2 is less up there at that altitude d/w the low Pb. He's hyperventilating, so O2 is less, pCo2 is low. If he were tostay there a bit longer (say for example a week)....one would notice a rise in HCO3 to compensate, as such the pH would be normal.

Wht do you all think?

Note these are from the released ABA q's. nothing fishy.

 

[poresofkohn]

Whywould a young guy that lives at sealevel, ater having gone hiking at 14,000 feet have a ABG of: 7.55 pH, CO2 of 24, O2 of 57? My take. The pO2 is less up there at that altitude d/w the low Pb. He's hyperventilating, so O2 is less, pCo2 is low. If he were tostay there a bit longer (say for example a week)....one would notice a rise in HCO3 to compensate, as such the pH would be normal.

Wht do you all think?

Note these are from the released ABA q's. nothing fishy.

I would think he is hyperventilating (hence the alkalosis) because of the low pO2, not the other way around. Also, a rise in HCO3 would add to the alkalosis raising the pH even further......no? I think he'd acclimate to the lower Pb and stop hyperventilating once the pO2 came up a bit.

 

[poresofkohn]

Doing some questions last minute here:

Does someone with Idiopathic Pulm fibrosis have any special ABG derangements? (like how COPDers retain CO2). I'm assuming their O2 on RA is slightly low, but their pH should really be normal (since it's chronic and compensated). CO2 should be normal.

I've always understood IPF to be a restrictive lung disease with diffusion deficiencies, so hypoxemia is often seen. Depending on the severity of the restrictive process ventilation may be comprimised as well so the acid base element of the ABG may be abnormal as well.

 

[PinchandBurn]

I've always understood IPF to be a restrictive lung disease with diffusion deficiencies, so hypoxemia is often seen. Depending on the severity of the restrictive process ventilation may be comprimised as well so the acid base element of the ABG may be abnormal as well.

So are you saying hteres a decrement in the DLCO? I thought that was for obx dz states like emphysema.

THe book has the answer for a ptient with IPF as on RA pH- 7.39 co2-41 paO2-59
Which is prtty normal, except for a lower O2.

 

[Idiopathic]

DLCO reduction is seen in most all lung diseases that result in hypoxemia (restrictive, obstructive and fibrotic). Certainly its seen in IPF.

 

[Hernandez]

Doing some questions last minute here:

Does someone with Idiopathic Pulm fibrosis have any special ABG derangements? (like how COPDers retain CO2). I'm assuming their O2 on RA is slightly low, but their pH should really be normal (since it's chronic and compensated). CO2 should be normal.

Whywould a young guy that lives at sealevel, ater having gone hiking at 14,000 feet have a ABG of: 7.55 pH, CO2 of 24, O2 of 57? My take. The pO2 is less up there at that altitude d/w the low Pb. He's hyperventilating, so O2 is less, pCo2 is low. If he were tostay there a bit longer (say for example a week)....one would notice a rise in HCO3 to compensate, as such the pH would be normal.

Wht do you all think?

Note these are from the released ABA q's. nothing fishy.

IPF tends to be more hypoxemic with the decreased DLCO than hypercarbic, but if they have enough restriction or fibrosis they can be come hypercarbic. And you will develop a metabolic alkalosis to compensate for a chronic hypocapnia even if the cause for the hypocapnia is hypoxemia.