Lab Case 121

A 2 month old girl is brought in by her parents with shortness of breath on a background of a 2 day viral illness. She is cool to touch with significantly increased work of breathing. Clinically, the patient presents as a bronchiolitis. Her capillary refill is 7 seconds.

Her blood gas shows:pH  6.77  (7.36-7.44)

pCO2  43  (35-45  mmHg)

HCO3  6  (22-26  mmol/l)

BE  -28

Na  135  (137-145  mmol/l)

K  4.8  (3.5-5  mmol/l)

Cl  106  (99-111  mmol/l)

Creatinine  33  (<130  umol/l)

Glucose  17.5  (4-6  mmol/l)

Lactate  22  (<1.3  mmol/l)

Describe and interpret the blood tests

How would you treat the patient?

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