Lab Case 207

A 24 year old female presents with vomiting and abdominal pain. She is drowsy, febrile and pale.

Vital signs:

BP  90 systolic

HR 120/min

T 38

RR 26/min

After initial resuscitation her blood gas is as follows:pH  6.99

pCO2  22

HCO3  5

BE  -26

Na  139

K  5.2

Cl  114

Creat  64

Hb  143

Lactate  3.4

Describe and interpret the VBG

One thought on “Lab Case 207

  1. HAGMA. Lactate alone does not explain derangement. Would like to see glucose level to establish if DKA. Could be sepsis driving DKA, which explains the fever, lactate and the derangements. Creatinine normal but would follow closely with urine output to see if acute kidney injury a component. Lastly, measure and calculate osmolality – high osmolar gap suggestive of toxins (salycilates, etyhlene glycol, methanol).

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