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Some patients have lung disease or other respiratory pathology that chronically limits their ability to achieve a minute ventilation high enough to keep their PaCO2 in a normal range and their body compensates for the high PaCO2 and low pH by allowing the kidneys to retain more of the alkalotic bicarbonate ion (HCO3-) to neutralize the acidic CO2 and bring the pH back toward the normal 7.
The early post-operative ventilator settings were intended to keep Jonathan alkalotic to reduce pulmonary hypertension.
When whole blood was exposed to air for 3 min, there was no measurable change in pH, but plasma became steadily alkalotic, with a >10% fall in [[H.