Chronic respiratory acidosis
PAO2 (at 0100) =
150-(1.2x 58 )= 80
PAO2-PaO2 = 80-44 = 36
Indicates abnormal gas exchange
Renal effort to compensate for Respiratory acidosis.
The process is chronic
To treat acute bronchitis
are the common organisms to cause acute exacerbation in COPD.
Hypoxic stimulus to increase ventilation abolished by oxygen administration
Hypoxemia due to V/Q abnormality rather than shunt
Patient's decline in FEV1 is approximately 100 ml/yr. (normal 30 ml/yr.)
Hyperinflation of RV and TLC at the expense of VC
The patient is more like the classic pink puffer (type A emphysema).
Pink Puffer (type A emphysema):
Blue Bloater (type B chronic bronchitis):
Driving Pressure: Pel = Palv - Ppl (pel decreased in emphysema)
Unopposed outward recoil of the chest wall from loss of inward recoil of lung (decreased Pel)
Diffusion capacity in:
Chronic bronchitis - Normal
Asthma - Normal or increased
Emphysema - Decreased