Question

Two patients, both in respiratory distress, present to your hospital when you have only a single ventilator available. Each has a history of emphysema and each wants “everything possible done.” Results of ABG testing of the first patient show PO2 = 68 mmHg, PCO2 = 58 mmHg, and HCO3– = 22 mEq/L. Results for the second patient are PO2 = 59 mmHg, PCO2 = 75 mmHg, and HCO3– = 38 mEq/L. All else being equal and based purely on ABG analysis, which patient should get the ventilator?

Answer 1

Normal values for ABG analysis as below:-

PO2= 100mmHg(75-100mmHg)

PCO2=40mmHg(35-45mmHg)

HCO3-= 24 new/L(22-28mEq/L)

If the PO2 is below 60mmHg, the condition is called hypoxia and PCO2 levels more than 60mmHg called as hypercapnia.

The first patient show PO2 = 68 mmHg, PCO2 = 58 mmHg, and HCO3– = 22 mEq/L.

The second patient are PO2 = 59 mmHg, PCO2 = 75 mmHg, and HCO3– = 38 mEq/L.

After interpreting the above two patients values, it has been concluded that second patient is suffering from hypoxia (as PO2 is decreased ), respiratory acidosis and metabolic Alkalosis (as HCO3- levels are higher).

So that the patient should be kept on positive pressure ventilation. So that second person is at most required for ventilator.