Case 12. Smoke Inhalation

Question 1

Describe the pulmonary gas exchange and acid base status:

PO2.       47!     On 15L FiO2
PCO2.     4.5
H+.          44     PH 7.36
HCO3.     18
Lactate.     2.                   High
Sats.         100%.             False reading

Answer 1

Gas exchange is normal but there is a severe hypoxaemia
Compensated metabolic acidosis

The heamaglobin is swamped by CO leading to tissue hypoxaemia resulting in anaerobic respiration in the tissues and lactic acid production. Hence the early primary metabolic acidosis.