Thankyou for your passion in the field!. Your students are extremely blessed to have you. Thankyou for giving everyone else outside of your class an insight to your wisdom.
I understand conceptually but when you says “co2 back to 40” do you mean an equal increase in Bicarbonate? Like a 1:1 of co2 and bi carb? So if co2 is at 41 would you need a 1 base excess?
Hey I have a question. What if patient has e respiratory alkalosis and bicarb is normal but there is a base deficit? What does it imply? Does it imply that there is a compensation?
Could you help me with this question? In which situation and which are ph and BE values that need bicarb iv administration? I'm a med student,and I've seen a case with methabolic acidosis,ph 6.9 and BE -22( patient with DM, that didn't respected insulin treatment for 3,4 days, we believe, even if he said that just one day he didn't got his medicine,in just one day it's impossible to reach 6.9 ph). We gave bicarb, insulin+glucose
Dose of bicarb as far is i know is 0.5 x pt weight in kg x (pt bicarb- target bicarb). Target bicarb usually 15. To give 50% of it in first 4 hours and the rest in 24 hrs. To always correct potassium before correcting bicarb.
Hi, Mohamed. I don't think there's been a superior mode documented for the treatment of COVID-19. Even ARDS.NET doesn't specify a preferred mode. Just a focus on Vt 4-8 ml/kg, depending on plateau pressure. Driving pressure, plateau-peep, comes into play in recent years. Driving preasures less than 15cwp have shown positive outcomes. I think the key is to not shoot for normal values, instead think adequate ventilation and oxygenation. That will keep you from over stressing the alveoli in an attempt to achieve normal values. Can't point to any one study in any of that, rather a collective thought associated with multiple studies. Hope that helps my man. Best wishes!
Really helpful explanation, took me a bit to get my head around it because I work in England and ABGs are measure in KPa. Either way it was really helpful and also gave me a refresher on compensated and uncompensated scenarios 🙂
Hi, Dr. Shah! Yes, that's correct. To be exact, to have a 7.39 pH with a CO2 of 56, HCO3 would actually be 32.8 (not 34). Thanks for watching and commenting.
I really appreciated what you have been doing for simplifying one of the most complicated issues in ICU.
Thankyou for your passion in the field!. Your students are extremely blessed to have you. Thankyou for giving everyone else outside of your class an insight to your wisdom.
You are a great teacher
What would you expect the respiratory rate to be for the example of respiratory alkalosis in this example?
thanks for this great explanation :) knowing how to interpret BE can make everything so much easier
100%! Thanks for watching and commenting!
Based on Base(excess/ deficit) in which level . .. does the patient needs to receive an Bicarb IV?
Very useful for a Respiratory Therapy Student
I understand conceptually but when you says “co2 back to 40” do you mean an equal increase in Bicarbonate? Like a 1:1 of co2 and bi carb? So if co2 is at 41 would you need a 1 base excess?
Hey I have a question. What if patient has e respiratory alkalosis and bicarb is normal but there is a base deficit? What does it imply? Does it imply that there is a compensation?
so BE is howmuch the bicarb is deviated from its normal range ..right ?
Medical student here, found this helpful
Could you help me with this question? In which situation and which are ph and BE values that need bicarb iv administration?
I'm a med student,and I've seen a case with methabolic acidosis,ph 6.9 and BE -22( patient with DM, that didn't respected insulin treatment for 3,4 days, we believe, even if he said that just one day he didn't got his medicine,in just one day it's impossible to reach 6.9 ph). We gave bicarb, insulin+glucose
Dose of bicarb as far is i know is 0.5 x pt weight in kg x (pt bicarb- target bicarb). Target bicarb usually 15. To give 50% of it in first 4 hours and the rest in 24 hrs. To always correct potassium before correcting bicarb.
May I ask.. why need to correct potassium first before bicarb?@@sayakshinobu
You are the best teacher!
Very helpful explanation, thank you
Cool, Ashraf! Glad it was helpful! And thank you for watching.
You are a reaaly great teacher! Thanks a lot
Thanks man you helped me
amazing tutor
Thank you
I really appreciated what you are doing and I really enjoyed it. My question is what mode is good for covid- 19( pressure or volume control)
Hi, Mohamed. I don't think there's been a superior mode documented for the treatment of COVID-19. Even ARDS.NET doesn't specify a preferred mode. Just a focus on Vt 4-8 ml/kg, depending on plateau pressure. Driving pressure, plateau-peep, comes into play in recent years. Driving preasures less than 15cwp have shown positive outcomes. I think the key is to not shoot for normal values, instead think adequate ventilation and oxygenation. That will keep you from over stressing the alveoli in an attempt to achieve normal values. Can't point to any one study in any of that, rather a collective thought associated with multiple studies. Hope that helps my man. Best wishes!
So helpful. Thank you
Really helpful explanation, took me a bit to get my head around it because I work in England and ABGs are measure in KPa. Either way it was really helpful and also gave me a refresher on compensated and uncompensated scenarios 🙂
Hello from across the pond. Glad you found it helpful. Thanks for watching and kindly commenting.
thank you !
Thank u so much, from italy ❤️
Awesome explanation!!!! I have a question:when Hco3 =34 how will the BE be +7??? Won’t it be 34-24=10 ?
Hi, Dr. Shah! Yes, that's correct. To be exact, to have a 7.39 pH with a CO2 of 56, HCO3 would actually be 32.8 (not 34). Thanks for watching and commenting.
@@RespiratoryCoach thank you sir..but I couldn't get it.please explain me..if possible
I have the same doubt. Your calculations are not matching all the time. Need more explanation. Are you calculating from 22 , 24 or from 26. ?
thanks a lot
man you're good... what a great video... EMT-P FP-C Candidate/
How do you determine BE based on ABGs? Can you?
Its usually given in abg reports
Nice
Thanks for watching, Thara.
Thanks but not clear to me yet.