A 39 year old man presents to your ED with altered mental state.

His blood results show:

pH 6.884

pCO2   17.7 mmHg  (35-45)

HCO3   3.2   (24+/-2)

BE   -31

Na  131 mmol/l  (137-145)

K  5.9 mmol/l  (3.5-5)

Cl  103 mmol/l  (99-111)

Glu  24.3 mmol/l   (4-6)

Lactate   2.3 mmol/l  (<2)

Creat  89  (<130)

Questions:

1. Describe and interpret
2. What are the key feature in airway/ breathing management in this patient?