What do blood gas results of pH 7.07, PCO2 62 torr, and PO2 45 torr indicate in a 28-week gestation neonate receiving 40% oxygen?

The blood gas results of pH 7.07, PCO2 62 torr, and PO2 45 torr indicate a significant acid-base imbalance, primarily characterized by a low pH and elevated carbon dioxide levels. A pH of 7.07 is acidosis, as the normal range is approximately 7.35 to 7.45. The PCO2 of 62 torr is notably high and indicates that there is inadequate ventilation leading to CO2 retention, which is a hallmark of respiratory acidosis.

In this context, the low PO2 of 45 torr further confirms the presence of hypoxemia, indicating that oxygen levels are critically low. Given that the neonate is already receiving oxygen, the hypoxemia suggests a more complex respiratory issue possibly due to immaturity of the lungs or other respiratory complications common in preterm neonates.

The key elements are that the pH is low (indicating acidosis), the PCO2 is high (confirming respiratory acidosis), and the presence of hypoxemia. The lack of compensatory mechanisms, as evidenced by the low pH and high PCO2 without a corresponding significant reduction in bicarbonate levels that would suggest metabolic compensation, leads to the conclusion that