Lab Case 4 – Interpretation

Critically ill patient requiring immediate resuscitation and concurrent assessment

4 important features:

HAGMA – DKA most likely, also Renal failure. possible sepsis as cause ppt cause of DKA

Additional respiratory acidosis – not just poor compensation, CO2 is high (expect low if compenation). Hypoventilation (altered GCS), also consider COPD, pneumonia, aspiration

High glucose – DKA

Renal failure

Consider other causes of low GCS

Speciifcs:

pH 7.05, HCO3 low => severe life threatening metabolic acidosis

raised anion gap —– therefore HAGMA

compensation – Winters formula

-expected CO2 is 35, actual 66

Aa gradient 27 — high, implying VQ mismatch or shunt

K high but actual likely to be lower

Elevated Urea and Creatinine

 

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One thought on “Lab Case 4 – Interpretation

  1. In my opinion HCO3 – are too high as expected (history + for COPD with CO2 elevated and renal compensation? ).

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