Lab Case 136 – Interpretation

A 34 year old female with chronic underlying lung disease presents with a life threatening exacerbation of her respiratory disease.Acute on chronic respiratory acidosis

partial metabolic compensation – expected HCO3 44 if chronic with normal pH

Normal anion gap

unable to calculate A-a gradient

Treatment options to consider:

oxygen restriction

bronchodilators/ steroids/antibiotics – what is the cause of her acute deterioration?

BiPAP – care due to underlying chronic lung disease

intubation

Limits of care

 

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