PH = 7.39, that is within the normal range.

pCO2 = 30 mmHg, that is slightly low. This patient might have respiratory alkalosis.

Next, we should look at the compensation for respiratory acidosis. (This patient is 2 years old. The condition will be acute).

For the compensation of acute respiratory alkalosis, we expect HCO3 to drop by 2 mmol for every 10 pCO2 below 40.  Accordingly, expected HCO3 should be 22 mmol/L.

This patient’s HCO3 is 20 mmol/L. That is slightly lower than expected. This patient might have additional metabolic acidosis.

Next, we need to calculate the anion gap, to find out what type of metabolic acidosis this patient has.

Anion gap is calculated as AG = Na – (Cl + HCO3) = 14. This patient has HAGMA.

This patient has acute respiratory alkalosis with associated HAGMA.

Other abnormal findings

Lactate = 4.3 mmol/L, that is hyperlactataemia. Secondary to nebulized adrenaline. HAGMA is due to high lactate level.