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It is slower than the initial bicarbonate buffer system in the blood, but faster than renal compensation. Respiratory compensation usually begins within minutes to hours, but alone will not completely return arterial pH to a normal value (7.4). Winter's Formula quantifies the amount of respiratory compensation during metabolic acidosis. [8]
The amount of respiratory compensation in metabolic acidosis can be estimated using Winters' formula. [2] Hyperventilation due to the compensation for metabolic acidosis persists for 24 to 48 hours after correction of the acidosis, and can lead to respiratory alkalosis. [3] This compensation process can occur within minutes. [4]
A RSBI score of less than 65 [3] indicating a relatively low respiratory rate compared to tidal volume is generally considered as an indication of weaning readiness. A patient with a rapid shallow breathing index (RSBI) of less than 105 has an approximately 80% chance of being successfully extubated, whereas an RSBI of greater than 105 virtually guarantees weaning failure. [4]
Integrated pulmonary index (IPI) is a patient pulmonary index which uses information from capnography and pulse oximetry to provide a single value that describes the patient's respiratory status. IPI is used by clinicians to quickly assess the patient's respiratory status to determine the need for additional clinical assessment or intervention.
Ventilation Curve – Plot VE vs. VO 2 or Watts or Time – The point at which there is a non‐linear increase in ventilation; V‐Slope Method – Plot VO 2 vs. VCO 2 – The point at which the increase in VCO 2 is greater than the increase in VO 2
Respiratory compensation is also a condition where increased respiration reduces carbon dioxide sometimes to level below the normal range. In this case it is a physiological response to low pH from metabolic processes and not the primary disorder.
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Recall that the relationship represented in a Davenport diagram is a relationship between three variables: P CO 2, bicarbonate concentration and pH.Thus, Fig. 7 can be thought of as a topographical map—that is, a two-dimensional representation of a three-dimensional surface—where each isopleth indicates a different partial pressure or “altitude.”