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Topic:Hypoxemia

Hypoxemia in horses refers to a condition characterized by low levels of oxygen in the blood. It can occur due to various respiratory or circulatory issues, impacting the horse's overall health and performance. Causes of hypoxemia in horses may include pulmonary diseases, airway obstructions, or cardiovascular problems. The condition is identified through clinical signs and diagnostic tests, such as arterial blood gas analysis. Monitoring and managing hypoxemia are essential for maintaining equine health, particularly in athletic horses or those undergoing anesthesia. This page compiles peer-reviewed research studies and scholarly articles that explore the causes, diagnosis, and management of hypoxemia in horses.
[Farmer’s lung disease caused by straw or hay? Case report].
Laeknabladid    September 13, 2005   Volume 91, Issue 7-8 587-589 
Gudmundsson G, Olafsson L, Nikulásson S, Jónsdóttir B.A young woman was admitted to Akranes Regional Hospital because of dyspnea, fatigue and fever. She was found to have bilateral pneumonia but etiology was not found. She was treated with antibiotics with good resolution and was discharged after eight days from the hospital. Four weeks later she noticed rapidly progressive dyspnea and was found to be hypoxemic, and to have restrictive spirometry and diffuse interstitial changes on chest radiography. Computerized tomography of the lungs showed diffuse ground glass changes. Transbronchial biopsies from the lungs showed numerous small granulomas. S...
Intrapulmonary arteriovenous shunts of >15 microm in diameter probably do not contribute to arterial hypoxemia in maximally exercising Thoroughbred horses.
Journal of applied physiology (Bethesda, Md. : 1985)    March 17, 2005   Volume 99, Issue 1 224-229 doi: 10.1152/japplphysiol.01230.2004
Manohar M, Goetz TE.The present study examined whether Thoroughbred horses performing strenuous exercise exhibit intrapulmonary arteriovenous shunting that may contribute to the observed arterial hypoxemia. Experiments were carried out on seven healthy, exercise-trained Thoroughbreds at rest, maximal exercise (galloping at 14 m/s on a 3.5% uphill grade for 120 s), and submaximal exertion (8 m/s on a 3.5% uphill grade for 150 s). Along with blood gas/hemodynamic parameters, intrapulmonary arteriovenous shunting was studied by injecting 15-microm-diameter microspheres, labeled with different stable isotopes, into t...
Treatment for a severe reaction to intravenous administration of diatrizoate in an anesthetized horse.
Journal of the American Veterinary Medical Association    April 13, 2004   Volume 224, Issue 7 1143-1112 doi: 10.2460/javma.2004.224.1143
Gunkel CI, Valverde A, Robertson SA, Thompson MS, Keoughan CG, Ferrell EA.A mature horse developed acute signs of bronchoconstriction causing hypoxemia and hypercapnia during anesthesia for computerized tomography of the maxillary sinus after i.v. administration of diatrizoate contrast medium. The horse was treated with aerosolized albuterol, atropine, and oxygen insufflation and recovered uneventfully despite severe hypoxemia and low hemoglobin saturation. The horse's condition continued to improve after treatment, and the horse was discharged with no further complications. Caution is advised with the use of contrast media in anesthetized horses.
Risk factors and prognostic variables for survival of foals with radiographic evidence of pulmonary disease.
Journal of veterinary internal medicine    December 9, 2003   Volume 17, Issue 6 868-875 doi: 10.1111/j.1939-1676.2003.tb02527.x
Bedenice D, Heuwieser W, Solano M, Rand W, Paradis MR.The medical records of 163 neonatal foals that had thoracic radiographs taken within 48 hours of admission to a referral hospital were reviewed. The objectives of this study were (1) to identify risk factors for the development of thoracic radiographic changes and (2) to identify prognostic indicators for survival in foals with radiographic evidence of pulmonary disease. Failure of transfer of passive immunity (IgG concentration < or = 400 mg/dL) was the only risk factor for radiographic evidence of respiratory disease identified by multivariate analysis. Hypoxemic patients (PaO2 1.7 mg/dL...
Clinical observations during induction and recovery of xylazine-midazolam- propofol anesthesia in horses.
The Journal of veterinary medical science    August 27, 2003   Volume 65, Issue 7 805-808 doi: 10.1292/jvms.65.805
Oku K, Yamanaka T, Ashihara N, Kawasaki K, Mizuno Y, Fujinaga T.To evaluate clinical usefulness of xylazine (1.0 mg/kg)-midazolam (20 microg/kg)-propofol (3.0 mg/kg) anesthesia in horses, 6 adult Thoroughbred horses were examined. The quality of induction varied from poor to excellent and 5 out of 6 horses presented myotonus in the front half of the body. However, paddling immediately after induction observed in other reports of equine propofol anesthesia was not observed. Recovery time was 35.3 +/- 9.3 min and the quality of recovery was calm and smooth in all horses. Respiration rate decreased after induction and hypoxemia was observed during lateral rec...
Does haemorheology explain the paradox of hypoxemia during exercise in elite athletes or thoroughbred horses?
Clinical hemorheology and microcirculation    June 26, 2002   Volume 26, Issue 3 175-181 
Caillaud C, Connes P, Bouix D, Mercier J.Exercise-induced arterial hypoxemia (EIAH), i.e., a significant drop of O2 arterial partial pressure during sea level exercise, has been shown in both aerobically trained athletes and athletic animal species. The mechanisms potentially involved include ventilation/perfusion inequality and/or pulmonary diffusing capacity limitation. In thoroughbred horses, EIAH is going with pulmonary haemorrhage (EIPH). Stress failure of pulmonary capillaries leading to diffusion limitation has been proposed. Indeed, during intense exercise, the increased cardiac output and blood viscosity combine to rise capi...
Mechanistic basis for the gas exchange threshold in Thoroughbred horses.
Journal of applied physiology (Bethesda, Md. : 1985)    March 16, 2002   Volume 92, Issue 4 1499-1505 doi: 10.1152/japplphysiol.00909.2001
McDonough P, Kindig CA, Erickson HH, Poole DC.The exercising Thoroughbred horse (TB) is capable of exceptional cardiopulmonary performance. However, because the ventilatory equivalent for O2 (VE/VO2) does not increase above the gas exchange threshold (Tge), hypercapnia and hypoxemia accompany intense exercise in the TB compared with humans, in whom VE/VO2 increases during supra-Tge work, which both removes the CO2 produced by the HCO buffering of lactic acid and prevents arterial partial pressure of CO2 (PaCO2) from rising. We used breath-by-breath techniques to analyze the relationship between CO2 output (VCO2) and VO2 [V-slope lactate t...
Extravascular lung water in the exercising horse.
Journal of applied physiology (Bethesda, Md. : 1985)    November 22, 2001   Volume 91, Issue 6 2442-2450 doi: 10.1152/jappl.2001.91.6.2442
Wilkins PA, Gleed RD, Krivitski NM, Dobson A.Seven Standardbred horses were exercised on a treadmill at speeds (approximately 12 m/s) producing maximal heart rate, hypoxemia, and a mean pulmonary arterial pressure of approximately 75 mmHg. Extravascular lung water was measured by using transients in temperature and electrical impedance of the blood caused by a bolus injection of cold saline solution. Lung water was approximately 3 ml/kg body wt when standing but did not increase significantly with exertion. We conclude that any increase in fluid extravasation from the pulmonary hypertension accumulates in the lung at a level that is less...
Nasal strips do not affect pulmonary gas exchange, anaerobic metabolism, or EIPH in exercising Thoroughbreds.
Journal of applied physiology (Bethesda, Md. : 1985)    May 18, 2001   Volume 90, Issue 6 2378-2385 doi: 10.1152/jappl.2001.90.6.2378
Goetz TE, Manohar M, Hassan AS, Baker GJ.The present study was carried out to examine whether nasal strip application would improve the exercise-induced arterial hypoxemia and hypercapnia, diminish anaerobic metabolism, and modify the incidence of exercise-induced pulmonary hemorrhage (EIPH) in horses. Two sets of experiments, control and nasal strip experiments, were carried out on seven healthy, sound, exercise-trained Thoroughbred horses in random order, 7 days apart. Simultaneous measurements of core temperature, arterial and mixed venous blood gases/pH, and blood lactate and ammonia concentrations were made at rest, during subma...
Effect of prior high-intensity exercise on exercise-induced arterial hypoxemia in Thoroughbred horses.
Journal of applied physiology (Bethesda, Md. : 1985)    May 18, 2001   Volume 90, Issue 6 2371-2377 doi: 10.1152/jappl.2001.90.6.2371
Manohar M, Goetz TE, Hassan AS.Strenuously exercising horses exhibit arterial hypoxemia and exercise-induced pulmonary hemorrhage (EIPH), the latter resulting from stress failure of pulmonary capillaries. The present study was carried out to examine whether the structural changes in the blood-gas barrier caused by a prior bout of high-intensity short-term exercise capable of inducing EIPH would affect the arterial hypoxemia induced during a successive bout of exercise performed at the same workload. Two sets of experiments, double- and single-exercise-bout experiments, were carried out on seven healthy, sound Thoroughbred h...
Assessment of muscle oxygenation in the horse by near infrared spectroscopy.
Equine veterinary journal    February 8, 2000   Volume 32, Issue 1 59-64 doi: 10.2746/042516400777611973
Pringle J, Roberts C, Art T, Lekeux P.This study examined the ability of near infrared spectroscopy (NIRS) to noninvasively determine changes to muscle oxygenation in the resting horse. Five horses had (NIRS) performed over extremity muscle while under general anaesthesia, first with 8 min limb ischaemia, then systemic hypoxaemia for 5 min. A second group of 6 awake horses had NIRS performed over extremity muscle while being administered hypoxic gas (F(I)O2 0.10) for 5 min, and after return to steady state, limb ischaemia was induced for an additional 5 min. In the anaesthetised horses' ischaemia induced marked and significant mus...
Ventilation-perfusion relationships during exercise in standardbred trotters with red cell hypervolaemia.
Equine veterinary journal. Supplement    February 5, 2000   Issue 30 107-113 doi: 10.1111/j.2042-3306.1999.tb05199.x
Funkquist P, Wagner PD, Hedenstierna G, Persson SG, Nyman G.In order to evaluate the pulmonary gas exchange during exercise in Standardbred trotters with red cell hypervolaemia (RCHV), 12 horses with RCHV were compared with 9 normovolaemic (NV) horses. VO2 and VCO2 were determined with an open bias flow system. Cardiovascular and haemodynamic data were recorded during exercise at 4 different speeds on a treadmill. Pulmonary gas exchange was assessed by conventional blood gas variables (arterial and mixed venous blood gas tensions), and the ventilation-perfusion distribution VA/Q was estimated by the multiple inert gas elimination technique. VA and AaDO...
Effect of breathing frequency and airflow on pulmonary function in high-intensity equine exercise.
Equine veterinary journal. Supplement    February 5, 2000   Issue 30 19-23 doi: 10.1111/j.2042-3306.1999.tb05181.x
Bayly WM, Redman MJ, Sides RH.It has been postulated that the hypoxaemia and hypercapnoea that characterize strenuous equine exercise are partly due to flow limitations imposed by high breathing frequencies (fb), and that gas exchange would be improved if fb could be lowered. To evaluate this possibility, 6 Thoroughbred horses underwent 4 incremental treadmill exercise tests at inclines of 0, 5, 10 and 25%, respectively. In the test, horses were given a warm-up for 2 min, then ran sequentially for 1 min each at 60, 100 and 115% VO2max. Oxygen consumption (VO2), blood gas tensions (PaO2, PaCO2), fb, tidal volume (VT), minut...
Blood gas, plasma lactate and bronchoalveolar lavage cytology analyses in racehorses with respiratory disease.
Equine veterinary journal. Supplement    February 5, 2000   Issue 30 77-82 doi: 10.1111/j.2042-3306.1999.tb05193.x
Couëtil LL, Denicola DB.The purpose of this study was to evaluate the relationship between bronchoalveolar lavage (BAL) cytology, arterial blood gases and plasma lactate concentration during a standardised treadmill test (STT) in racehorses with small-airway inflammation (SAI), or exercise-induced pulmonary haemorrhage (EIPH). Sixteen Thoroughbred and 20 Standardbred actively racing racehorses, were divided into a control group (n = 10), EIPH group (n = 13) and SAI group (n = 13). Each STT consisted of a 2 min trot at 4 m/s followed by 5 x 1 min, incremental speed steps (6, 8, 10, 11 and 12 m/s) at 10% incline for Th...
Gangrene in the distal extremity of all 4 limbs of a 2-week-old foal.
The Canadian veterinary journal = La revue veterinaire canadienne    January 11, 2000   Volume 41, Issue 11 861-863 
Steinman A, Orgad U, Sutton GA.Wet gangrene developed in all 4 limbs following repair of a rupture in the lower urinary tract in a 2-week-old foal. Dehydration and hypoxemia are suspected as the inciting causes of the necrosis.
Regional distribution of blood flow in the brain of horses at rest and during exercise.
American journal of veterinary research    July 11, 1998   Volume 59, Issue 7 893-897 
Manohar M, Goetz TE.To examine regional distribution of blood flow in the brain of horses at rest and during exercise. Methods: 9 clinically normal horses. Methods: Regional brain blood flow was measured using radionuclide-labeled 15-microns-diameter microspheres injected into the left ventricle, while reference blood samples were obtained from the aorta. Results: At rest, cerebral cortex and caudate nuclei received significantly higher blood flow, compared with cerebral white matter. A similar perfusion heterogeneity existed in the cerebellum. In the brain stem, a gradual tapering of blood flow from thalamus-hyp...
Effect of high-intensity exercise on arterial blood gas tensions and upper airway and cardiac function in clinically normal quarter horses and horses heterozygous and homozygous for hyperkalemic periodic paralysis.
American journal of veterinary research    May 16, 1998   Volume 59, Issue 5 615-618 
Maxson-Sage A, Parente EJ, Beech J, Lindborg S, May LL, Teleis DC.To determine the effect of exercise on arterial blood gas tensions and upper airway and cardiac function in clinically normal Quarter Horses and horses heterozygous and homozygous for hyperkalemic periodic paralysis (HYPP). ANIMALS AND PROCEDURE: 5 clinically normal Quarter Horses, and 5 heterozygous and 2 homozygous HYPP-affected horses were examined before, during, and after exercise on a high-speed treadmill. Arterial blood gas tensions, ECG, and echocardiogram were obtained prior to exercise. Upper airway endoscopy, collection of arterial blood samples, and continuous electrocardiography w...
Does an acute COPD crisis modify the cardiorespiratory and ventilatory adjustments to exercise in horses?
Journal of applied physiology (Bethesda, Md. : 1985)    April 16, 1998   Volume 84, Issue 3 845-852 doi: 10.1152/jappl.1998.84.3.845
Art T, Duvivier DH, Votion D, Anciaux N, Vandenput S, Bayly WM, Lekeux P.The present study was conducted to understand better the mechanisms leading to the decrease in exercise capacity observed in horses suffering from chronic obstructive pulmonary disease (COPD). Five COPD horses were submitted to a standardized submaximal treadmill exercise test while they were in clinical remission or in acute crisis. Respiratory airflow, O2 and CO2 fractions in the respired gas, pleural pressure changes and heart rate were recorded, and arterial and mixed venous blood were analyzed for gas tensions, hemoglobin, and plasma lactate concentrations. O2 consumption, CO2 production,...
Catecholamines, enkephalins and the response of the fetal adrenal medulla to hypoxaemia.
Equine veterinary journal. Supplement    June 1, 1997   Issue 24 68-73 doi: 10.1111/j.2042-3306.1997.tb05081.x
McMillen IC, Simonetta G, Roberts ML, Adams MB.No abstract available
Cerebrospinal fluid acid-base status during normocapnia and acute hypercapnia in equine neonates.
American journal of veterinary research    October 1, 1996   Volume 57, Issue 10 1483-1487 
Geiser DR, Andrews FM, Rohrbach BW, Provenza MK.To determine normal acid-base status of the CSF and to compare it with changes during acute hypercapnia in equine neonates. Methods: 10 clinically normal foals between 1 and 12 days old. Methods: CSF and arterial and venous blood samples were collected every 15 minutes during 45 minutes of normocapnia and 90 minutes of hypercapnia in isoflurane-anesthetized foals. CSF samples were collected via a subarachnoid catheter placed in the atlanto-occipital space. Results: Comparison of blood and CSF gases during normocapnia indicated that CSF was significantly more acidic than blood. The lower pH was...
Effects of inhalation anesthetic agents on response of horses to three hours of hypoxemia.
American journal of veterinary research    March 1, 1996   Volume 57, Issue 3 351-360 
Whitehair KJ, Steffey EP, Woliner MJ, Willits NH.To study the effects of inhalation anesthetic agents on the response of horses to 3 hours of hypoxemia. Methods: Controlled crossover study. Methods: Five healthy adult horses. Methods: Horses were anesthetized twice: once with halothane, and once with isoflurane in O2. Anesthetized horses were positioned in left lateral recumbency. Constant conditions for the study began at 2 hours of anesthesia. A constant agent dose of 1.2 minimum alveolar concentration, PaO2 of 50 +/- 5 mm of Hg, and PaCO2 of 45 +/- 5 mm of Hg were maintained for 3 hours. Circulatory measurements were made at 0.5, 1, 2, an...
Effects of additional premedication on romifidine and ketamine anaesthesia in horses.
Acta veterinaria Scandinavica    January 1, 1996   Volume 37, Issue 3 315-325 doi: 10.1186/BF03548097
Marntell S, Nyman G.The clinical and cardiorespiratory effects of premedication with acepromazine, butorphanol or diazepam in addition to romifidine before induction of anaesthesia with ketamine were studied in 6 horses on 4 random occasions. Administration of romifidine alone or in combination with butorphanol resulted in an increase in arterial blood pressure, accompanied by a significant decrease in heart rate with second-degree atrio-ventricular heart block. Induction of anaesthesia with ketamine returned the heart rate to baseline value, but the arterial blood pressure was significantly increased compared to...
Ventilatory and arterial blood gas tension adjustments to strenuous exercise in standardbreds.
American journal of veterinary research    October 1, 1995   Volume 56, Issue 10 1332-1337 
Art T, Lekeux P.Five healthy, fit Standardbreds (mean +/- SEM, 490.4 +/- 15.0 kg, 4.0 +/- 0.5 years) were studied during a standardized test carried out on a treadmill. The test consisted of an 8-minute warm-up and a 9-minute exercise period (1 minute at 1.7, 4, 7, 8, 9, and 10 m/s; 2 minutes at 4 m/s; and a 1-minute walk at a 6% slope). Respiratory airflow, tidal volume (V(T)), and respiratory frequency (f) were continuously recorded, using 2 ultrasonic pneumotachographs connected to a face mask and mass spectrometer. Oxygen uptake, carbon dioxide output, and expired minute volume (V(E)) were obtained on a b...
Evaluation of a modification of the Hudson demand valve in ventilated and spontaneously breathing horses.
The Veterinary record    December 10, 1994   Volume 135, Issue 24 569-572 
Johnson CB, Adam EN, Taylor PM.Hypoxaemia commonly develops during general anaesthesia and in the recovery period in horses. The Hudson demand valve has been used to increase arterial PO2, but it has been found to increase airway resistance considerably when used during spontaneous ventilation. This paper evaluates a modification of the valve designed to reduce this resistance. The effects of the valve and its modification on arterial oxygen (PaO2), and carbon dioxide (PaCO2) tensions were evaluated in four ponies anaesthetised by a total intravenous technique. The valve increased PaO2 from 8.3 +/- 1.1 to 32.7 +/- 7.6 kPa d...
Effects of clenbuterol hydrochloride on pulmonary gas exchange and hemodynamics in anesthetized horses.
American journal of veterinary research    May 1, 1993   Volume 54, Issue 5 776-782 
Dodam JR, Moon RE, Olson NC, Exposito AJ, Fawcett TA, Huang YC, Theil DR, Camporesi E, Swanson CR.We evaluated the effects of clenbuterol HCl (0.8 micrograms/kg, of body weight, IV), a beta 2 agonist, on ventilation-perfusion matching and hemodynamic variables in anesthetized (by IV route), laterally recumbent horses. The multiple inert gas elimination technique was used to assess pulmonary gas exchange. Clenbuterol HCl induced a decrease in arterial oxygen tension (from 57.0 +/- 1.8 to 49.3 +/- 1.2 mm of Hg; mean +/- SEM) as a result of increased shunt fraction (from 6.6 +/- 2.1 to 14.4 +/- 3.1%) and ventilation to regions with high ventilation-perfusion ratios. In contrast, no changes in...
Xylazine-ketamine and detomidine-tiletamine-zolazepam anesthesia in horses.
Veterinary surgery : VS    July 1, 1992   Volume 21, Issue 4 312-318 doi: 10.1111/j.1532-950x.1992.tb00072.x
Wan PY, Trim CM, Mueller PO.Eight horses were anesthetized three times, by intravenous administration of xylazine (1.1 mg/kg) and ketamine (2.2 mg/kg), detomidine (0.02 mg/kg) and tiletamine-zolazepam (1.1 mg/kg), or detomidine (0.04 mg/kg) and tiletamine-zolazepam (1.4 mg/kg). The sequences were randomized. The duration of analgesia and the times to sternal and standing positions were recorded. Heart rate, arterial pressure, pHa, PaCO2, and PaO2 were measured before and during anesthesia. The duration of analgesia with the two doses of detomidine-tiletamine-zolazepam, 26 +/- 4 minutes and 39 +/- 11 minutes, respectively...
Electrocardiographic findings during parturition and blood gas tensions immediately after birth in thoroughbred foals.
The Japanese journal of veterinary research    December 1, 1991   Volume 39, Issue 2-4 143-157 
Yamamoto K, Yasuda J, Too K.In 101 newborn Thoroughbred foals and foaling mares, 45 fetal (FECGs) and 101 neonatal electrocardiograms (NECGs) were obtained to investigate neonatal arrhythmias and other parameters including changes in fetal (FHR) and neonatal heart rate (NHR). Moreover, umbilical arterial, venous and jugular venous blood gas tensions and pH immediately after birth were analyzed to compare with the type and the degree of neonatal arrhythmias. Before delivery, in 37 fetuses FHR gradually decreased while in 8 cases it increased after rupture of the chorio-allantois. Abnormal deliveries were related in 5 of t...
Exercise-induced hypercapnia in the horse.
Journal of applied physiology (Bethesda, Md. : 1985)    November 1, 1989   Volume 67, Issue 5 1958-1966 doi: 10.1152/jappl.1989.67.5.1958
Bayly WM, Hodgson DR, Schulz DA, Dempsey JA, Gollnick PD.The effects of exercise intensity and duration on blood gases in thoroughbred horses were studied to characterize the apparent exercise-induced failure in pulmonary gas exchange that occurs in these animals. In response to 2 min of exercise, arterial CO2 tension (PaCO2) decreased in mild and moderate exercise, returned to normocapnic levels in moderate to heavy exercise, and rose 5-10 Torr above resting values during very heavy exercise when CO2 production (VCO2) exceeded 20 times the resting value, and mixed venous CO2 tension approximated 140 Torr. Exercise-induced hypoxemia occurred at the ...
Pulmonary vascular reactivity of the newborn pony foal.
Equine veterinary journal    May 1, 1989   Volume 21, Issue 3 181-185 doi: 10.1111/j.2042-3306.1989.tb02137.x
Drummond WH, Sanchez IR, Kosch PC, Webb AI.Adult ponies develop pulmonary hypertension at altitude (Bisgard, Orr and Will 1975), but the neonatal response to acute hypoxaemia is unknown. Seven foals aged five days were instrumented with a systemic and a Swan-Ganz pulmonary artery catheter while anesthetised and intubated. Cardiac index, pulmonary (PAP) and systemic (SAP) vascular pressures were measured as the foals breathed gas mixtures with FI02 of 8 to 94 per cent. Because foramen ovale or ductus arteriosus shunts might have altered thermodilution cardiac index measurements in the stressed foals, the ratio, PAP/SAP was calculated to...
Mechanism of exercise-induced hypoxemia in horses.
Journal of applied physiology (Bethesda, Md. : 1985)    March 1, 1989   Volume 66, Issue 3 1227-1233 doi: 10.1152/jappl.1989.66.3.1227
Wagner PD, Gillespie JR, Landgren GL, Fedde MR, Jones BW, DeBowes RM, Pieschl RL, Erickson HH.Arterial hypoxemia has been reported in horses during heavy exercise, but its mechanism has not been determined. With the use of the multiple inert gas elimination technique, we studied five horses, each on two separate occasions, to determine the physiological basis of the hypoxemia that developed during horizontal treadmill exercise at speeds of 4, 10, 12, and 13-14 m/s. Mean, blood temperature-corrected, arterial PO2 fell from 89.4 Torr at rest to 80.7 and 72.1 Torr at 12 and 13-14 m/s, respectively, whereas corresponding PaCO2 values were 40.3, 40.3, and 39.2 Torr. Alveolar-arterial PO2 di...