Lab case 399

38 year old lady presented to the emergency department with recurrent vomiting. She was found to have a slipped lapband. Her venous blood gases showed the following

PH = 7.43

pCO2 = 61 mmHg

pO2 = 26 mmHg

HCO3- = 39.9 mmol/L

Na+ = 136 mmol/L

K+ = 2.4 mmol/L

Cl- = 90 mmol/L

Glucose = 5.4 mmol/L

Lactate = 1.6 mmol/L

Creatinine = 92 umol/L

Questions:

 

  1. Interpret these blood gases?
  2. What are the possible causes?
  3. How will you manage this patient?