An 89 year old man presents with history of feeling unwell for 4 days. He is a NIDDM.

GCS 14-15

Vitals:

BP 90/60

PR 100/min

RR 25/min

His blood gas shows:

pH  7.302  (7.36-7.44)

pCO  35  (35-45 mmHg)

HCO3  16.7  (22-26 mmol/l)

BE  -8  (-3-+3)

Na  160  (136-145  mmo/l)

K  5  (3.4-5  mmmol/l)

Cl  124  (99-111  mmol/l)

glucose  36  (4-6  mmol/l)

Lactate  6.7  (<2  mmol/l)

Creat  306  (<130 umol/l)

Describe and Interpret his gas

What are the causes/ precipitating factors?

How would you treat him?