Advertisement

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

      This paper is only available as a PDF. To read, Please Download here.

      Abstract

      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.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to The American Journal of Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Refsum H.E.
        Acid-base disturbances in chronic pulmonary disease.
        Ann. New York Acad. Sc. 1966; 133: 142
        • Robin E.D.
        Abnormalities of acid-base regulation in chronic pulmonary disease with special reference to hypercapnia and extracellular alkalosis.
        New England J. Med. 1963; 268: 917
        • Van Slyke D.D.
        • Neill J.M.
        Determination of gases in blood and other solutions by vacuum extraction and manometric measurement. I.
        J. Biol. Chem. 1924; 61: 523
        • Van Slyke D.D.
        • Sendroy Jr., J.
        Studies of gas and electrolyte equilibria in blood. XV. Line charts for graphic calculations by Henderson-Hasselbach Equation, and for calculating plasma carbon dioxide content from whole blood content.
        J. Biol. Chem. 1928; 79: 781
        • Murray J.F.
        Carbon dioxide retention without acidosis; common occurrence due to coexisting potassium depletion.
        Am. Rev. Resp. Dis. 1962; 86: 126
        • Comroe Jr., J.H.
        • Bahnson E.R.
        • Coates E.O.
        Mental changes occurring in clinically anoxemic patients during oxygen therapy.
        J.A.M.A. 1950; 143: 1044
        • Sieker H.O.
        • Hickam J.B.
        Carbon dioxide intoxication: the clinical syndrome, its etiology and management.
        Medicine. 1956; 35: 389
        • Bradley R.D.
        • Semple S.J.G.
        A comparison of certain acid-base characteristics of arterial blood, jugular venous blood and cerebrospinal fluid in man, and the effect on them of some acute and chronic acid-base disturbances.
        J. Physiol. 1962; 160: 381
        • Campbell E.J.M.
        A method of controlled oxygen administration which reduces the risk of carbon dioxide retention.
        Lancet. 1960; 2: 12
        • Campbell E.J.M.
        Methods of oxygen administration in respiratory failure.
        Ann. New York Acad Sc. 1965; 121: 861
        • Campbell E.J.M.
        • Gebbie T.
        Masks and tent for providing controlled oxygen concentration.
        Lancet. 1966; 1: 468