Pao2 64.00 level

[KKCAL]

In my latest spirometry/LFT  test shows- Pao2=64.00 mmHg,, Ph=7.44,  Paco2=35.00 mmHg,,
Base excess=0.01 mEq/L,,02 stauration=93.00%,,  Hgb=13.00g/dl..Hematocrit=42.00%
Today have seen Respiratory specialist, he was explaining this is sure under breath syndrome, which does not have any treatment except BIPAP, further explaining that this is ideopathic.
Very confused what to do now, age 55, BMI 41, he ruled out success of CPAP and ruled out that this is not obs sleep apnea
Please suggest some expectations.  

[ChrisBSRRT]

There are several causes of isolated low Pa02 measurements. First you will need a full set of pulmonary function tests including lung volumes and DLCO to better assess how well your lungs are diffusing oxygen and if your lung volumes are below normal. Simple spirometry will not tell this in a diagnostic manner. First it would be wise to rule out lung disease by performing the aforementioned exams, a CT will also visually show lung health and are commonly ordered in conjunction with PFT's.

Your description of "under breathing" sounds to me like it's describing not breathing enough, which contradicts the blood gas values you received. Your pH and PCo2 levels are normal, the faster or deeper your breathing the lower the PCo2 will get. The normal ranges are 35-45torr for PCo2, you're on the end of the normal range teetering toward hyperventilation(breathing too fast/deep). This alone will not diagnose any issue, someone that just walked briskly or is anxious can show these blood gas readings. The Pa02 is little low, but to get to the route cause of it the tests I mentioned should be performed to better understand how your body is working. Pulmonary hypertension is another disease that can render the very results you listed as normal, except the Pa02.

[Paderla Anitha, DNB]

Hi, what is the reason for under breath syndrome? in some disorders like muscular dystrophies, BiPAP is advocated. Bilevel positive airway pressure, is similar to CPAP therapy. However with BiPAP therapy there are two different pressure settings for the patient. It can be described as pressure controlled ventilation in a system allowing unrestricted spontaneous breathing, as the pressures vary for inspiration and expiration. So, it could help improve your O2 sats.          
Please discuss this with your doctor am sure he will provide further assistance. Regards.