Diagnosis

I am a 52 year-old woman and have been diagnosed by a pulmonologist as having Obstructive Sleep Apnea, Pulmonary Atelectasis Secondary to Obesity, and Cor Pulmonale.  I also have mild COPD.  

I had an ABG test performed in the past few days with the following results:

pH:  7.478
PCO2:  38.1
PO2:  52 mmHg
HCO3:  28.3 mmol/L
BEecf:  5 mmol/L
sO2:  89% (calculated)

I am currently on BiPAP with 6L of oxygen per night.

I just have a couple of questions.

1.  Have you ever heard of Pulmonary Atelectasis Secondary to Obesity (what I see online is related to anesthessia)?
2.  How bad is my PO2 reading of 52?
3.  What, in you opinion, is my prognosis?

Thanks for all your help and for providing this service to, effectively, the world but most of all to me!

[National Jewish Health]

Atelectasis occurs when there is pressure on the small airways of the lung that causes them to close up.  In obesity, the size of the abdomen can be cause of such atelectasis.  It is, of course, more prominent when the person in lying down.

A PO2 of 52 is a significant problem.  It is worth discussing wearing O2 24 hours a day.  This should be discussed with your Pulmonologist.

Without having a complete set of information, including lab tests, chest x-ray and a physical examination, this is not a good question for me to answer.  I would, however, suggest from the little information you have presented:

1. Make a significant effort at losing weight and beginning a sustained exercise program
2. Consider 24 hour a day oxygen therapy