A 28-year-old man is admitted to the emergency department with suspected drug overdose
The patient is obtunded and slightly cyanotic. The ABG results obtained while the patient was breathing room air were: pH 7.24; PaCO2 58 mm Hg; PaO2 52 mm Hg; HCO3? 24 mEq/L. The most appropriate interpretation of these results is which of the following?
a. Chronic respiratory failure
b. Hypoxemic respiratory failure
c. Hypercapnic respiratory failure
d. Acute or chronic respiratory failure
ANS: C
This arterial blood gas shows an uncompensated respiratory acidosis with moderate hypoxemia. A patient with chronic respiratory failure would show an elevated bicarbonate (HCO3−) due to the chronic respiratory failure. A patient with acute or chronic respiratory failure would have an elevated partial pressure of carbon dioxide in the arteries (PaCO2) that is higher than what the pa-tient's current HCO3− can compensate for. Hypoxemic respiratory failure will only show a de-creased partial pressure of oxygen in the arteries (PaO2) unless the hypoxemia is so severe that the patient's ventilation is compromised.
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