13. *In respiratory disturbances : .If ABG,s show only that PaO 2 is < 60 mmHg Hypoxaemic ( type I ) Respiratory Failure . .If PaO 2 < 60 mmHg & PaCO 2 > 45mmHg, Hypoxaemic , Hypercapnic ( type II ) Respiratory Failure .
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15. Measures to improve ventilation 1. Enhancing alveolar ventilation i.e treatment of the cause ( drug over dose / central hypoventilation / neuromuscular disease / airway obstruction ) . 2. Decrease CO 2 production -Bring fever down . -Avoid excessive nutritional calories .
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17. 2. Treatment of the cause . 3. Anaemic patients should be transfused to haemoglobin of 10 gm % .
18. adequate delivery of oxygenated blood to tissues . 4. Hypotensive patients should be resuscitated to an adequate cardiac output to assure
19. EXAMPLE 1 PH 7.34 (academia ) Pa CO2 48 ( academia ) Pa O2 129 ( normal ) HCO3 – 26 ( normal ) BE + 1 ( normal ) Sa O 2 99 % ( normal ) Interpretation Respiratory acidosis , adequate oxygenation.
20. EXAMPLE 2 PH 7.40 ( normal ) Pa CO2 58 ( academia ) Pa O2 57 ( hypoxemia ) HCO3 – 35 ( alkalemia ) BE + 9 ( alkalemia ) Sa O 2 89 % ( hypoxemia ) Interpretation Respiratory acidosis with complete metabolic compensation and hypoxemia .
21. EXAMPLE 3 PH 7.29 (academia ) Pa CO2 40 ( normal ) Pa O2 192 ( normal ) HCO3 – 19 (academia ) BE - 5.6 (academia ) Sa O 2 97.5 % ( normal ) Interpretation Metabolic acidosis with no compensation , adequate oxygenation.
22. EXAMPLE 4 PH 7.37 ( normal ) Pa CO2 40 ( normal ) Pa O2 126 ( academia ) HCO3 – 20 ( academia ) BE - 3.1 ( academia) Sa O 2 98 % ( normal ) Interpretation Fully compensated metabolic acidosis , adequate oxygenation.
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