3-year-old girl was brought to the emergency department with abdominal pain started 2 days before presenting to ED. She developed fever and vomited 3 times 6 hours before presentation. She had loss of appetite and kept on falling asleep.

Her Blood gases (venous) showed

PH = 7.28

PCO2 = 24.3

PO2 = 87.5

HCO3 = 11.1

Hb = 120

Na = 133

K = 4.2

Cl = 108

Glucose = 4.5

Lactate = 0.9

Creatinine = 33

Blood Ketones = 6.9

Question:

1 – Interpret this child’s blood gases results

2 – What are the potential causes of this presentation?