A 17 year old male previously healthy, presents to your ED feeling unwell with a fever.

BP = 100/70,   PR = 105/min,   RR 25/min

His VBG is as follows:

pH   7.19    (7.36-7.44)

pCO2  43   (36-44 mmHg)

pO2  37   (80-95 mmHg)

HCO3  16  (20-26 mmol/L)

BE   -11   (-2 –+4)

Na   137   (136-145 mmol/L)

K  4.0  (3.4-4.5 mmol/L)

Cl  102  (99-107 mmol/L)

Glucose  20.8   (3-8 mmol/L)

Lactate  2.5  (<2.0  mmol/L)

Questions:

1. Describe the acdi base abnormality and give the most likely cause

2. Describe the Potassium level

3. What are the commonest underlying causes?

4. What are the diagnostic criteria for this condition?

5. List your treatment aims

6. What are the commonest causes of mortality in these patients?