A 65-year-old male with COPD presents with acute worsening of breathlessness. He has widespread expiratory wheeze. His blood gas on a portable analyse...

Question

A 65-year-old male with COPD presents with acute worsening of breathlessness. He has widespread expiratory wheeze. His blood gas on a portable analyser shows pH 7.28, PaCO2 8.2 kPa, PaO2 7.1 kPa, HCO3 32 mmol/L. What does the elevated bicarbonate suggest about his respiratory failure?

Accepted Answer

Acute-on-chronic type 2 respiratory failure - the raised bicarbonate indicates chronic CO2 retention with renal compensation, with an acute decompensation

Answer

Metabolic alkalosis causing the respiratory failure

Answer

Diabetic ketoacidosis with respiratory compensation

Answer

Acute type 2 respiratory failure without any chronic component

Answer

Acute type 1 respiratory failure - the bicarbonate is irrelevant

uk-dipimc MCQ (SBA): Acute-on-Chronic Respiratory Failure

A 65-year-old male with COPD presents with acute worsening of breathlessness. He has widespread expiratory wheeze. His blood gas on a portable analyser shows pH 7.28, PaCO2 8.2 kPa, PaO2 7.1 kPa, HCO3 32 mmol/L. What does the elevated bicarbonate suggest about his respiratory failure?