A 34 year old female presents with acute shortness of breath. She is usually on home oxygen and has the use of a BiPAP machine.

She was born at 28 weeks, smokes and is obese

Her venous gas shows:pH  7.20  (7.36-7.44)

pCO2  102  (35-45  mmHg)

HCO3  38  (22-26  mmol/l)

Be  7

Na  141  (137-145  mmol/l)

K  3.9  (3.5-5  mmol/l)

Cl  96  (99-111  mmol/l)

Creat  34  (<130  umol/l)

Lactate 1.5

Describe and interpret

What are your treatment options?