30 year old healthy man with no previous medical conditions. He was brought by an ambulance with severe shortness of breath, he was diagnosed with viral URTI 2 days before this presentation. SPO2 = 92% on 10L oxygen through a face mask. Respiratory rate was 32/min. Pulse rate was 132/ min and blood pressure was 174/101. On Auscultation he had bilateral generalized crepitation.

His Arterial blood gas showed the following:

PH = 7.28

PaO2 = 107 mmHg

PaCO2 = 62 mmHg

HCO3 = 20 mmol/L

Na = 134 mmol/L

K = 3.7 mmol/L

Cl = 96 mmol/L

Cr = 54 umol/L

Glucose = 12.3 mmol/L

Lactate = 5.2 mmol/L

Questions:

1.  Interpret these results ?
2.  How will you manage this case ?
3.  What will be your ventilating stratigies ?