A 14-year-old male experiences a severe asthma attack with shallow breathing. Which ABG finding suggests the poorest prognosis?

The ABG finding indicative of the poorest prognosis in a patient experiencing a severe asthma attack is characterized by a low pH along with elevated pCO2 and low pO2. In this case, a pH of 7.27 signifies acidosis, which indicates respiratory failure and potentially diminished oxygenation. The elevated pCO2 of 46 reflects hypoventilation or an inability to effectively expel carbon dioxide, leading to respiratory acidosis, while the low pO2 of 56 indicates significant hypoxemia.

These values collectively suggest a critical state where the patient's respiratory system is failing to maintain appropriate acid-base balance and effective gas exchange. A pH below 7.30 is particularly alarming because it not only shows an acute deterioration in the acid-base status but also implies a higher likelihood of needing urgent medical intervention, such as intubation or mechanical ventilation, to stabilize the patient's condition.

In contrast, the other options reflect conditions that are either within normal or less critical ranges. For example, a pH of 7.60 with a low pCO2 indicates a possible compensatory respiratory alkalosis, often seen with hyperventilation. Values within the normal range suggest that the patient's respiratory function, while possibly disturbed