Author Topic: PLEASE ALL THE DOCTORS COME HERE ans me ASAP  (Read 4191 times)

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Offline Dr.Bint Alamoudi

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PLEASE ALL THE DOCTORS COME HERE ans me ASAP
« on: January 21, 2008, 10:36:06 PM »
SALAAM 3ALYKUM ALL
please try to help me and my friend understand the condition of his grandmother

-her lungs are not pumping CO2 out
-she has an history of asthma
-she was on constant ventilator for first 4 days
-her CO2 rises to 63
-now her ph-7.327
             CO2- 63.9
             O2- 62.7
-she is not able to exhale co2
-she is 83 years old
-she weighs 73 to 80 kgs
-she has stone in her kidney as well
-she is also diabetic


so tell me what is wrong with her and what is the next suppose to be



Offline Dr.Bint Alamoudi

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Re: PLEASE ALL THE DOCTORS COME HERE ans me ASAP
« Reply #1 on: January 21, 2008, 11:54:47 PM »
salaam
where is everybody!!
its very important

Offline Admin

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Re: PLEASE ALL THE DOCTORS COME HERE ans me ASAP
« Reply #2 on: January 22, 2008, 12:40:37 AM »
SALAAM 3ALYKUM ALL
please try to help me and my friend understand the condition of his grandmother

-her lungs are not pumping CO2 out
-she has an history of asthma
-she was on constant ventilator for first 4 days
-her CO2 rises to 63
-now her pH-7.327
             CO2- 63.9
             O2- 62.7
-she is not able to exhale co2
-she is 83 years old
-she weighs 73 to 80 kgs
-she has stone in her kidney as well
-she is also diabetic


so tell me what is wrong with her and what is the next suppose to be

Although your case is not exactly clear, I will try my best to answer it:
First the parameters you gave here:
CO2- 63.9, Do you mean PO2? | Normal PCO2 35-45
O2- 62.7, Do you mean PCO2? | Normal PO2 80-100

The correlation of severity between acute asthma and arterial blood gases is poor. Mild-to-moderate asthma is typically associated with respiratory alkalosis and mild hypoxemia on the basis of ventilation-perfusion mismatching. Severe hypoxemia is quite uncommon in asthma. Normocapnia and hypercapnia do imply severe airflow obstruction, with FEV1 usually <25% of the predicted value.

She is diabetic but no sign of acidosis and her PH is quite normal, and would you tell us if that stone has effect on renal function, how about her urea and creatinine?

To confirm if she is suffering from severe asthma we need the following information:
1- the findings from examination (wheezing?)
2- does she take medications to treat her attacks?
3- does she have other symptoms from other superimposed infection (Pneumonia?)?
4- what about her PEFR?
5- did they do chest X-ray? (very important in this case, debilitated old lady with weight loss) also to exclude tumour causing airway obstruction????

SHE IS SUFFERING FROM SEVERE AIRFLOW OBSTRUCTION? DO URGENT X-RAY

Dr.Mahdi
"you never cure a patient, you treat pain often but you always comfort the patient."
www.somalidoc.com

 

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