Arterial Blood Gas Results and Relation to the Underlying Pathogenesis

This case study examines the arterial blood gas results of a 75-year-old man with a urinary tract infection and sepsis. The study analyzes the pH level, HCO3 level, PaO2 level, and PaCO3 level to understand the kidney function and identify metabolic acidosis and hypoxia. The results suggest that the urinary tract infection may have reached the kidney and disrupted its normal function.

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CASE STUDY
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CASE STUDY
Arterial blood gas results and relation to the underlying pathogenesis:
The case study represents a Urinary tract infection of a 75 years man who was admitted
to the emergency department because of sudden burning sensation while he was urinating and he
was experiencing pain in the lower abdomen which radiating into his right plan. Within 24 hours
he was diagnosed with Urinary tract infection and sepsis. He underwent Arterial blood gas test
which measures the level of oxygen in the blood, level of carbon dioxide and pH level of the
blood in order to gain the understanding of the kidney function. As per the result ABG tests or
arterial blood gases it has been observed that the pH level of the blood was low (7.25 ) from the
normal range ( 7.35 to 7.45), suggesting that the pH of the urine acidic in nature which further
result in metabolic acidosis. As discussed by Perkins (2016), the low pH level is the indication
of the acidosis and in order to evaluate the acidosis, the level of HCO3 is required to consider.
Taking an insight into the situation, HCO3 level is very low (15mmol/L ) considering the
normal range of HCO3 (22-32 mmol/L). The low level of HCO3 is observed because of
metabolic acidosis which is observed in the patient with dysfunctional kidney as a result of
urinary tract infection. Hence, the patient may be suffering from severe diarrhoea or metabolic
disorder (Akirov & Elis, 2016). Considering the PaO2 level of the patient, PaO2 level was
lower (75mmHg) in the patient compared the (80 to 100 mmHg) , indicating that the decreased
level of oxygen which was inhaled by the patient. As discussed by Khanal (2016), the decrease
level of oxygen provides the idea that maybe he is suffering from hypoxia. The hypoxia can be
observed because of the low level of sepsis and he had hypotension which further resulted in
difficulty in breathing (Rossaint & Zarbock,2015). The level of PaCO3 was also low for the
patient compared to normal carbon di oxide. The level of PaCO3 provides an indication of the
carbon dioxide level of blood and a low level of carbon di oxide highlight the presence of

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hypoxia. In the current context, it was observed that the acid-base balance of the patient was
disturbed because of excessive accumulation of acids which was generated because of metabolic
disorder (Rossaint & Zarbock,2015). The patient had a high negative value of base which further
indicated ketoacidosis and associated septic shock. The lactate concern of the patient was also
high, indicating that he had the severe condition and it is disrupting functions of other the body
(Rossaint & Zarbock,2015). The lactate accumulation usually observed when the body is
experiencing hypoxia or decrease of oxygen level (Liang, 2016). Hence, the result indicated that
the urinary tract infection may be reached to the kidney and disrupts the normal function of the
kidney. In order to reduce the severity, immediate pharmacological intervention is required to
design for supporting the wellbeing.

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References:
Akirov, A., & Elis, A. (2016). The prognostic significance of admission blood glucose levels in
patients with urinary tract infection. Diabetes research and clinical practice, 115, 99-
105.
Khanal, S. (2016). Utilization of Arterial Blood Gas Measurements in a Tertiary Care
Hospital. J Anesth Crit Care Open Access, 6(2), 00219.
Liang, S. Y. (2016). Sepsis and other infectious disease emergencies in the elderly. Emergency
Medicine Clinics, 34(3), 501-522.
Perkins, A. (2016). Using the ABG to identify acidosis. Nursing made Incredibly Easy, 14(2), 6-
9.
Rossaint, J., & Zarbock, A. (2015). Pathogenesis of multiple organ failure in sepsis. Critical
Reviews™ in Immunology, 35(4).