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man is noted to have a heart rate of 100/min, hemoglobin of 10 Gm/dL, and stroke volume of 50 ml.
Arterial blood gas analysis done while the patient is mechanically ventilated with an FiO2 of 1.0 and PEEP
of 10 cm H2O reveals: PaO2 = 100 mm Hg, arterial O2 saturation = 100%, pH = 7.30, PaCO2= 30 mEq/L, Be
= -10 mEq/L.
1. What is the pulmonary status of the patient?
2. Describe the existing acid-base imbalance
3. Calculate the oxygen delivery of the patient
KEVIN N. RIVERA
2308093378
Section B
12/17/2014
1. PaO2 / FiO2 ratio is 100 mm Hg and means that the patient is currently experiencing severe
ARDS. The PaO 2 /FiO 2 is 100 mmHg on ventilators setting that include PEEP 5 cm H 2 O.
2. There is metabolic acidosis due to lactate production caused by severe Acute respiratory
distress syndrome. Metabolic acidosis can occur because of an increase in endogenous acid
production (such as lactate and ketoacids), loss of bicarbonate (as in diarrhea), or accumulation
of endogenous acids (as in renal failure). Lactic acidosis is one the most common causes of highAG acidosis in the ICU. An increase in plasma l -lactate is most commonly due to increased
production of lactate in setting of an imbalance in oxygen supply and demand at the tissue level
(type A). Thus type A lactic acidosis is thought to be caused by tissue hypoperfusion and/or
severe hypoxemia, although in recent years this view is thought to be an oversimplification.
3. Oxygen Delivery
CaO2 = (Hgb x SaO2 x 1.36) + (PaO2 x 0.0031)
= (10 Gm/dl x 1.00 ml/Gm x1.36) + (100 mmHg x 0.0031)
= 13.6 ml/dl + 0.31 ml/dl