doyoudig
Forum Guru
Topics: 144
Posts: 613
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46 y/o Male w/ Scute Exacerbation of COPD. He is a known DM on metformin for 3 years. His ABG are
pH 7.23
PaO2 88
PaCo2 40
HCO3 16
What is his Acid Base Disorder?
1. M Acidosis
2. Resp Acidosis
3. Mixed Metablic + Resp Acidosis
4. Mixed Metabolic Acidosis & Resp Alkalosis
5. Normal Acid base Status
Gusy what I would like to know is, can somone show me how to come to the answer without using Winters Formula and with having to eliminate Answers, I ll be obliged
Trying to find out if winters Formula is necessary at any time to come to a conclusion???
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| doc_clotaire
Forum Guru
Topics: 159
Posts: 1,303
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Try this !
COPD -------------cronic respiratory acidosis
Metformin --------lactic acidosis -------metabolic acidosis
This patient should have a mixed respiratory and metabolic acidosis
3. Mixed Metabolic + Resp Acidosis
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| sailing boat
Forum Elite
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doc clotaire
if he were to have a rep acidosis, his paco2 would be high
dont u think so?
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| young_doc
Forum Guru
Topics: 58
Posts: 737
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Technically it is high Sailing boat.
Think of it this way, with the metabolic acidosis, the CO2 would be lowered.
So if there is a super-imposed Resp. Acidosis, the raise in CO2 would then bring it to normal!
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| sailing boat
Forum Elite
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agreed
good one
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| dharjma
Forum Senior
Topics: 11
Posts: 182
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calculate these disorders using Winter's formula. he is in respiratory acidosis
Winter's formula :
1.5 (HCO3-) + 8 = PaCO2 that you should expect in someone with that HCO3-
in the case above PaCO2 should be 32 according to Winter's formula, but instead in the stem it is 40. that means he is actually retaining more CO2 than he should (indicating resp acidosis!)
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