Question

A 50 year old female was shot in the right side of her chest .she is currently in the progrsssive care unit . Her arterial blood gases are as follows : pH -7.30 .PaO2 - 88 mmHg. PaCO2 -50 mmHg. Bicarbonate 26 mEg/L . Lactate 5 mg/dL. 1- does she have an acid base imbalance ? If so what type of imbalance ? 2- what likely caused her to have this condition ? 3 - Her condition continues to deteriorate . What actions should be taken to restore her acid base balance ?

Answer 1

A 50-year-old female was shot in the right side of her chest.

Her arterial blood gases are as follows : pH -7.30 .PaO2 - 88 mmHg. PaCO2 -50 mmHg. Bicarbonate 26 mEg/L . Lactate 5 mg/dL.

1. pH is 7.3, it is in an acidic state.

Here the reason is both PaCO2 50 mmHg and Lactate5mg/dl

Because PaCO2 is above 45mmHg so it is likey a Respiratory acidosis and Lactate is above 5mg/dl So, it may be a Lactic acidosis.

2. The reason for respiratory Acidosis is CO2 Retention Lungs and Reason For Lactic acidosis is Tissue damage. (Damaged tissue or Dead tissue release lactate into the blood)

3. If CO2 Continuously increase then the patient needs mechanical ventilation to wash out the Carbon Dioxide.

To washout Lactate, we need to start fluid therapy Because the only way to wash extra lactate from the body is by Urine.