Lab Case 60

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A 65 year old man presents to your ED with an altered mental state. He has a history of throat cancer with metastases to his brain.

His BP is 90/60, HR is 100/min

His VBG :

pH 7.05

pCO2 94 (37-50 mmHg)

pO2 64 (36-44 mmHg)

HCO3 26 (24+/- 2 mmol/l)

BE -5 (-2–+2)

Na 148 (137-145 mmol/l)

K 4.1 (3.4-5.0 mmol/l)

Cl 104 (99-111 mmol/l)

Glu 6.2 (3-5 mmol/l)

Lactate 12.3 (<1.5)

Questions:

  1. Describe the abnormalities
  2. Give a reasonable explanantion
  3. What are your treatment prioriities

Thanks Bilal and Shai