Abstract
Arterial blood gas analysis performed in 67 episodes who suffered cardiopulmonary arrest revealed that the degree of acidemia correlated with the location of the patient within the hospital: emergency department (ED), general hospital bed (HB), or intensive care unit (ICU). Acidemia was most severe in patients who pre sented either in the ED (pH = 7.15) or in a HB (pH = 7.10) as a result of combined metabolic (bicarbonate ion [HCO 3 -] = 20 ± 16 and 15 ± 10 mEq/L) and respiratory acidosis (arterial carbon dioxide tension [PaCO2] = 59 ± 30 and 50 ± 24 mm Hg). In contrast, patients in the ICU had only mild acidemia or even alkalemia (pH = 7.28); respiratory acidosis was un common in this setting (PaCO2 = 36 ± 18 mm Hg), and patients exhibited a degree of metabolic acidosis ([HCO3 - ] = 18 ± 8 mEq/L) similar to that seen in patients in EDS or HBS. This relative hypocarbia seen in patients in the ICU was attributed to the fact that most (14 of 22, 64% ) were already receiving mechanical ven tilation at the time of the cardiopulmonary arrest. Pa tients who were successfully resuscitated (20, 30% ) did not differ from those in whom resuscitation failed (47, 70% ) in degree of acidemia or location of arrest. Serum potassium levels obtained in 29 patients at the time of arrest revealed that serum potassium levels were greater than 5.2 mEq/L only 8 times; there was only one mea surement greater than 6.0 mEq/L, which did not corre late with the degree of acidemia.
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