Hello, may I ask what is the usually normal HCO3- or base excess range for metabolic compensation in COPD patient? In COPD patient with acute exacerbation, generally over what cut-off of HCO3- or base excess value should prompt investigation of other concurrent acid-base issue(eg. contraction alkalosis...). I hope to know the value because sometimes calculated the compensation is too time comsuming, a cut-off value help me alert other concurrent acid-base issue would be helpful. thanks
Would this not be a mixed resp acidosis + metabolic acidosis? Because the pt still has a COPD exacerbation on top of the renal failure. As opposed to it just being an underlying metabolic issue
Can I ask why in 02:51 you said once we use bipap the pt would be alkalotic? He base deficit is 10, so once we use bipap to wash out CO2, he still has metabolic acidosis issue, am I right?
I said “once they stabilize with everything else”. It might have been said fast on my part. You are correct for this patient, a bipap would only be a bandage and they would still be in a metabolic acidosis. But once the initial problem is addressed, you could quickly get the patient to be alkolotic without realizing their underlying problem was fixed.
If a patient has DKA, they might have a respiratory rate of 30-40 and present with respiratory symptoms yet the issue is 100% metabolic and the pH would be acidic until the metabolic issue gets corrected.
Thank you so much for explaining it. I am a RT student, and I found this very helpful.
Absolutely gobsmacked how easy you made it grasped bro 👏 👌
Thank you!
Perfectly explained mate
This cleared things up.
great explanation, thank you
Short and to the point. 👍
I enjoyed it
you are a STAR!!
Hello, may I ask what is the usually normal HCO3- or base excess range for metabolic compensation in COPD patient? In COPD patient with acute exacerbation, generally over what cut-off of HCO3- or base excess value should prompt investigation of other concurrent acid-base issue(eg. contraction alkalosis...). I hope to know the value because sometimes calculated the compensation is too time comsuming, a cut-off value help me alert other concurrent acid-base issue would be helpful. thanks
Would this not be a mixed resp acidosis + metabolic acidosis? Because the pt still has a COPD exacerbation on top of the renal failure. As opposed to it just being an underlying metabolic issue
Very helpful!!! 👍
Can I ask why in 02:51 you said once we use bipap the pt would be alkalotic? He base deficit is 10, so once we use bipap to wash out CO2, he still has metabolic acidosis issue, am I right?
I said “once they stabilize with everything else”. It might have been said fast on my part. You are correct for this patient, a bipap would only be a bandage and they would still be in a metabolic acidosis. But once the initial problem is addressed, you could quickly get the patient to be alkolotic without realizing their underlying problem was fixed.
@@DoldierMedia thanks for explanation !
Thanks boo 😊
Never understood it..
So when trying to understand base excess the ph of the pt isnt really used for determining a pt condition?
The base excess creates a better picture as to why the pH is out of whack.
The pt is still important in knowing what needs to be done. But pH alone doesn’t tell you if it’s a metabolic issue or respiratory issue.
If a patient has DKA, they might have a respiratory rate of 30-40 and present with respiratory symptoms yet the issue is 100% metabolic and the pH would be acidic until the metabolic issue gets corrected.
Sir. Please help. I have base excess. My pco2 is 42 and p02 is 76.
Base excess is 3.0
Hco3 is 28
Kind of in the same boat bro. HCO3 28, pO2 113.8, BE (B) is 4.2 and (ecf) is 3.7. Hard to breathe chest pain time to time super tired
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