Dear Dr Smith, thank you veru much for great presentation. Question: for the situation on 32-33 min with 65 y.o. veteran with COPD how we know that this is elevation of pCO2 out of proportion to HCO3 and not other way round (HCO3 lower than expected and thus metabolic acidosis)? and how we assess that pH is lower than in simple respiratory acidosis? Thank you very much.
Alexander, most serious acidoses have an increased anion gap. A chronic respiratory acidosis does not. So you would be able to tell this both by the clinical presentation (resp failure) and absence of large anion gap. Thanks for the great question. Steve Smith
DEAR READER: I have loved receiving your comments, but I am no longer able to moderate them. Since the vast majority are SPAM, I need to moderate them all. Therefore, comments will rarely be published any more. So Sorry.
Thanks a lot Dr Smith.
ReplyDeletejeez, Stephen. it was difficult for me in 1979, and still is.
ReplyDeletebut thank you so much. excellent video.
tom
Dr. Smith, This lecture was extremely helpful for a medical student such as me. Thank you for the hard work.
ReplyDeleteThanks for feedback!
DeleteIn case of acute on chronic respiratory acidosis, how will the ABG differ from that of chronic hypercapneia?
ReplyDeleteThanks in advance.
Ashwini
pCO2 will be elevated out of proportion to HCO3. pH will be lower than simple chronic resp acidosis.
DeleteDear Dr Smith, thank you veru much for great presentation. Question: for the situation on 32-33 min with 65 y.o. veteran with COPD how we know that this is elevation of pCO2 out of proportion to HCO3 and not other way round (HCO3 lower than expected and thus metabolic acidosis)? and how we assess that pH is lower than in simple respiratory acidosis? Thank you very much.
ReplyDeleteAlexander,
Deletemost serious acidoses have an increased anion gap. A chronic respiratory acidosis does not. So you would be able to tell this both by the clinical presentation (resp failure) and absence of large anion gap.
Thanks for the great question.
Steve Smith