70 year old female with shortness of breath and confusion
- Triple acid base disorder
High anion gap metabolic acidosis (19)
delta ratio 0.42 = mixed high and normal anion gap
compensation: expected CO2 18.5, actual = 30 – partially compensated or additional respiratory acidosis
additional:
elevated potassium
elevated chloride
2. HAGMA – renal failure – high potassium, other causes-fluid overload, intracranial lesion
DKA, toxins, sepsis less likely – normal lactae, glucose, ketones not given
NAGMA – Normal Saline administration – elevated chloride
Elevated CO2 – altered mental state
3. [table id=3 /]