we just had a full term with sever neonatal pneumonia been ventilated on sippv for hypoxia and fortuntaly we succeeded in weaning him .. however after weaning all his blood gases show respiratory alkalosis although he is not tachypniec for example for the last 2 days he shows ph 7.49 pco2 15 hco3 14 be -17 ....... ph 7.49 pco2 14 hco3 10 be -20

can u explain

It is interseting! It seems the almost compensated respiratory alkalosis by metablic acidosis. What were the blood gas values just before ventilation was taken away. What was the PIP for the patient when he was ventilated?

the blood gases before ventilation shows metabolic acidosis with hypoxia .. pip were alwys around 22

I agree with Yinghua, this could be a metabolic acidosis primarly which is over-compensated. How has the blood gases developed since birth? Are there any signs of other metabolic dearrangements (hypoglycemia, lactacidos etc)?

i have reservations about the ability of a newborn over compensaing metabolic acidosis especially if there is no tachypnea. I would look for metabolic derangements or frusemide use. Sorrry I have entered this discussion toooooo late