A patient with a measured plasma HCO3– concentration of 24 mmol/L has an episode of acute hypoventilation, with the PCO2 rising from 40 to 70 mm Hg. What do you predict will happen acutely to the plasma HCO3– concentration?
a. HCO3– will remain unchanged.
b. HCO3– will rise to approximately 27 to 28 mmol/L.
c. HCO3– will fall to approximately 20 to 21 mmol/L.
d. HCO3– will rise to approximately 54 to 55 mmol/L.
ANS: B
In general, when the nonbicarbonate buffer concentration is normal and the PCO2 rise is acute, the hydration reaction raises the plasma [HCO3–] approximately 1 mEq/L for every 10 mm Hg increase in PCO2 higher than 40 mm Hg.
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