How to calculate the approximate baseline pCO2 level in Arterial Blood Gas (ABG) in COPD patients

[@lazirus7692]

Thank doctor, this is very nice explanation 👏

[@TheICUChannel]

glad it was helpful

[@AkshayaValvaikar-d7n]

Thank u sir.

[@sadekur8505]

Excellent

[@saadkhan1205]

Great work guys

[@briekhnaa]

👍

[@binoyfernando1151]

very useful

[@pakvillagesecrets7440]

Thank you sir keep it up

[@TheICUChannel]

Thanks

[@Raghulraj]

Sir..... Kindly explain about the management of HHS and DKA in a simple precise manner as in ur all lecture videos....

[@TheICUChannel]

docs.google.com/forms/d/e/1FAIpQLScaY4fYpRmCKumdscZ5pUHYyv0Yg5aA3CKBPPz3V4CxTPxFRw/viewform

[@arslanali1432]

Can you kindly guide why book from where to study it. Thanks

[@drrafiq73]

❤❤❤❤❤❤❤

[@ravindra2688]

Sir PEEP functional residual capacity me kya change krta hai ??? Increase or decrease?????

[@TheICUChannel]

Ur question needs a video explaining all these stuff … will try to make

[@ravindra2688]

@@TheICUChannel thank you sir. Sir kya eska answer mil sakta hai muje 👇 It is decided that a client needs a ventilator. Her physician prescribes PEEP. When PEEP is used, all of the following occur except: A. Improved arterial oxygenation. B. Improved ventilation-perfusion. C. Increased alveolar dilation. D. Increased functional residual capacity.

[@TheICUChannel]

The best is option C as peep don’t increase the alveolar dilatation but it keeps the already dialated alveoli open.

[@LEARNING-MEDICAL-EDUCATION]

one video on renal tubular acidosis, sir

[@TheICUChannel]

sure

[@LEARNING-MEDICAL-EDUCATION]

in the first case, bicarbonate is 37. so, there is metabolic compensation also pushing ph in opposite direction, so, should not we also take that into consideration rather than just substracting acute from chronic component,

[@TheICUChannel]

pH is important as pH is acidotic is primary respiratory component; compensation NEVER overshoots. bicarb will not increase so much they raise pco2 upto a level which causes pH acidotic.

[@aniketdebnath6550]

In a respiratory acidosis patient the hco3 compensation will try to increase ph to normal values... in that case how to calculate the fall in ph due to co2 retention?

[@TheICUChannel]

See the full lecture , May be this be of help to you … kzbin.info/www/bejne/r3epg3d5eJijg9E

[@roshu4557]

Gud afternoon sir,is ventilation setting same for osa/copd or different?

[@TheICUChannel]

Different

[@roshu4557]

@@TheICUChannel so if pt is having respiratory acidosis with pco2 level of 100 we shd keep respiratory rate arnd 20 not 12 or 14 as we keep for copd pt?right This is my confusion

[@AliHamza-bz2oo]

How to achiev this target on CPAP by decreasing fIo2 or decreasing RR

[@TheICUChannel]

multiple factors, will try to cover in the ventilator video.

[@Russ92]

Can you use "winter's formula" to estimate baseline PaCO2 in chronic retainers whose bicarb is above 30?😮

[@nitinjain2089]

*No.It's for Expected PaCO2 in Metabolic Acidosis*

[@rizwanqureshi3832]

❤

[@rogerborok8543]

Hi. Am Dr Abhijit a practising intensive care doctor from Nagaland..I had a lady with diagnosis of ca lung (one cycle radiotherapy received) basically admitted a week ago..during the admission to icu from EMR the co2 was 89 & after calculation her base line co2 was around 85…till yesterday she was on HFNC for last 03 days but saturation drops drastically around 60 & ABG done @that point the Co2 was around 66 & got intubated! If u can comment on this.. Regards Dr Abhijit

[@TheICUChannel]

Post on icu.in/forums or telegram group

[@vsrockpatil7155]

Sir 2nd abg still pH is 7.3 pco2 74 If we calculate baseline pco2 now it will again 62

[@patrioticindian5194]

Hello sir One question What about when pt abg has compansation That is pco2 increases but PH donot change due to bicarb compansation In that case how to calculate it

[@TheICUChannel]

kzbin.info/www/bejne/r3epg3d5eJijg9E

[@roshu4557]

Sir if we reached baseline pco2 level in dis pt of 74 shd we stop niv further Wat to do after baseline pco2 level reached?

[@TheICUChannel]

yes, this is calculation ; one should reconfirm in abg when it reaches... and if pH gets corrected and patient gets clinically improved, we would have not used NIV just to correct the pco2.

[@Nehakumari-in9wh]

If,the patient has oxygen saturation above93and pulse rate below100 and patient feels always sleepy,is it sign of increase pco2 if patient is underweight and above 65 years old please reply sir.

[@TheICUChannel]

Do a blood gas and check .

[@umeshnagpal1332]

If PH-7.37 PCO2-70 AND HCO3-40.5 and patient came with breathing difficuly and k/c of copd, echo and chest ray normal then wat to do and po2-47

[@TheICUChannel]

See this patient is co2 retainer … at present seems like patient is in acute exacerbation, which requires Nebulization and steroids .. watch for Pt clinical status (drowsy ness etc ) . Also may require intermittent bipap support and also rule out PE

[@umeshnagpal1332]

@@TheICUChannel pt is conscious and oriented PE is ruled out i want to ask that should we correct the pco2 or not

[@TheICUChannel]

From what u posted , NO

[@umeshnagpal1332]

@@TheICUChannel ohk thanku very much