80 year old male known diabetic, re-presents to ED after a recent admission in which the patient was diagnosed with TB. According to the wife the patient has been home for 2 days. Over the last 24 hours his oral intake has declined and he has become less responsive.

VBG:

pH7.25                                               Na 140mmol/l

pCO2 30mmHg                                 K 4.6mmol/l

HCO3 15 mmol/l                               Cl 106mmol/l

B/E -11.2                                           Cr 73 umol/l

Lactate 9.5mmol/l                             BSL 1.3

• Describe and interpret the VBG