Use of oxygen inhalation in evaluation of respiratory acidosis in patients with apparent metabolic alkalosis

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      Respiratory failure presenting with normal or high pH because of associated metabolic alkalosis is commonly encountered and has received much attention. In such cases the respiratory acidosis may be inapparent and, therefore, may not be treated appropriately, with what may be serious consequences to the patient. A simple, readily available method is described to allow unmasking of the respiratory acidosis, and to separate patients with mixed respiratory acidosis-metabolic alkalosis from patients with pure metabolic alkalosis. This method is based on the observation that when inhaling 100 per cent oxygen for twelve minutes, overt respiratory acidosis often developed in patients with potential hypoventilation whatever their initial arterial gas values.
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