70 year old female presents critically unwell following collapse with altered mental state.
Severe respiratory acidosis
Additional metabolic acidosis – NAGMA, with high chloride (BE -10, expected HCO3 is 33 if acute respiratory acidosis)
Typre II respiraory failure
Severe hypoperfusion with elevated lactate, is AG normal because of Saline administration?
Has this patient had a cardiac arrest to account for this presentation, what is the cause?
Maintain blood pressure/ ?inotropes
Look for cause
Interestingly, this patient made a full neurologic recovery and was discharged home 2 weeks later. The cause was thought to be primary respiratory arrest, from respiratory failure.