You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information.
What is Interpret the following ABG values PaCO-40, HCO-55 mEq/L and pH-7.7: and explain in detail?
Ans: (a) Uncompensated metabolic alkalosisRef: Harrison's Principles of Internal Medicine, 19th edition,Chapter 66 20.Step 1: Review the patientExamine the patient for clues as to the type of disturbance.Step 2: Analyse the oxygenationLook for signs of hypoxia, by assessing the PaO and SaO.Step 3: Assess the pH: Is there an acidosis or alkalosis?pH<7.35 is an acidosis; pH>7.45 is an alkalosisStep 4: Assess for respiratory disturbanceConsider the state of alveolar ventilation by evaluating the PaCO.Step 5: Assess for metabolic disturbanceExamine HCO and BE in relation to pH, to determine metabolic involvement.Step 6: Establish if the disturbance is compensatory or mixedObserve the pH to determine if the compensation is appropriate for the primary disturbance (complete or partial)DisorderPrimary ChangeCompensatory ResponseMetabolicAcidosis||pCO1.2mmHg for every 1mEq/L|OR pCO=last two digits of pHMetabolicalkalosis||pCO0.7mmHg for every 1mEq/L|RespiratoryAcidosis|pCO Acute will |0.1mmol/L per mmHg| in PaCOChronic will |0.4mmol/Lper mmHg| in PaCORespiratoryalkalosis|pCO Acute will |0.2mmol/L per mmHg| in PaCOChronic will |0.4mmol/L per mmHg| in PaCO Normal levels of blood pH,pCO and HCOBlood levels criteriaVenousArterialpH7.35-7.407.38-7.45PCO45-50torr35-45torrHCO24-25mEq/L23-27mEq/LNormal ABG valuesH+(35-45nmol/L)<35=alkalemia,>45=academiapH(7.35-7.45)<7.35=acidemia,>7.45=alkalemiaPO(>10.6kPaor>80mmHg in arterial blood on room air)PCO(4.7-6.0kPaor35-45mmHg in arterial blood)SpO(>96% on room air)HCO (22-28mmol/L)BE (-2 to +2)Lactate (0.4-1.5mmol/L)Stepwise approach for acid-base disorderspH<7.35=acidosis; pH>7.45=alkalosisPrimary change in HCO-metabolicIf the change in HCO is in keeping with the pH (i.e., acidosis + decreased HCO), the problem is metabolicIf the change in HCO is opposite with the pH (i.e., acidosis + increased HCO), the problem is compensatory metabolicPrimary change in CO-respiratoryIf the change in CO is in keeping with the pH (i.e., acidosis + increased CO), the problem is respiratoryIf the change in CO is opposite with the pH (i.e., acidosis + decreased CO), the problem is compensatory respiratoryMixed acid-base disordersPresent when compensation is not appropriateCompensation never overcorrects the primary disturbance Expected compensationLimit of compensationMetabolic acidosisPCO=1.5x+8+-2PCO does not fall below 10 mm HgMetabolic alkalosisPCO increases by 7 mm Hg for each 10 mEq/L increase in serum PCO does not rise above 55mmHgAcute respiratory acidosis increases by 1 for each 10 mm Hg increase in PCOHCO does not rise above 30mEq/LChronic respiratory acidosis increases by 3.5 for each 10 mm Hg increase in PCOHCO does not rise above 45mEq/LAcute respiratory alkalosis falls by 2 for each 10 mm Hg decrease in PCOHCO does not fall below 18mEq/LChronic respiratory alkalosis falls by 4 for each 10 mm Hg decrease in PCOHCO does not fall below 12mEq/L