28 year old man presented to ED with nausea and vomiting for 5 days. His venous blood gases showed the following:

PH = 7.82

PaCo2 = 28.7 mmHg

PO2 = 108 mmHg

HCO3 = 49.4

Hb = 181 g/L

Na = 111 mmol/L

K = 2.5 mmol/L

Cl = 64 mmol/L

BSL = 7.2 mmol/L

Lactate = 3.0 mmol/L

Creatinine = 544 umol/L

Questions:

1. Interpret these blood gases results
2. What are the potential causes of these changes?
3. How will you manage this patient?