Lab case 407

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56 year old man with background of type 2 DM. Presented after a fall at home. He was presyncopal with blood pressure of 60/50 and pulse rate of 50/ min. (Normal sinus rhythm).

His Arterial blood gases (on 3L Oxygen)showed the following:

PH = 7.12

pCO2 = 23 mmHg

pO2 = 105 mmHg

HCO3 = 7 mmol/L

Na = 136 mmol/L

K = 4.4 mmol/L

Cl = 112 mmol/L

Calcium (Ionised) = 1.22 mmol/L

Hb = 109 mmol/L

Glucose = 14.2 mmol/L

Lactate = 11 mmol/L

Creatinine = 130 umol/L

 

Questions:

  •  Interpret these results
  • What are the possible causes?
  • How will you manage this patient?