40 year old female presents with haematemasis and a 2 day history of malaena.  The patient is well known to your ED with alcohol related presentations. She has been told by her GP that her liver function tests are abnormal.

Vitals: BP 80/40 HR 130 RR 23 Sats 96% RA Apyrexial

VBG

pH  7.194                                             Na 143 mmol/l

pCO2 33 mmHg                                  K   4.9 mmol/l

HCO3 13  mmol/l                                Ca 1.05mmol/l

BE -13.8mmol/l                                   Cl   109mmol/l

HB 48 g/L                                            Lactate  6.4 mmol/l

Glucose 6.4 mmol/l                            Cr  90 umol/l

1. Describe and Interpret the above VBG
2. Discuss the management of this patient