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:
bronchodilators/ steroids/antibiotics – what is the cause of her acute deterioration?
BiPAP – care due to underlying chronic lung disease
Limits of care