A 49 year old man with confusion, hypothermia and shock requiring urgent resuscitation has blood results which show
The same patient in Lab Case 148
uncompensated, or additional respiratory acidosis
Delta ratio of 2.0 – likely HAGMA without metabolic alkalosis
severe total body K depletion
likely severe DKA BUT if lactate is 3.8 and ketones are 6.9 what accounts for the rest of the anion gap?
What if I told you his measured osmolality was 357?
How would you treat him?