70 year old female presents critically unwell following collapse with altered mental state.
- Abnormalities:
Severe respiratory acidosis
Additional metabolic acidosis – NAGMA, with high chloride (BE -10, expected HCO3 is 33 if acute respiratory acidosis)
Elevated Lactate
2.
Typre II respiraory failure
Severe hypoperfusion with elevated lactate, is AG normal because of Saline administration?
Has this patient had a cardiac arrest to account for this presentation, what is the cause?
3.
Intubate, hyperventilate
Maintain blood pressure/ ?inotropes
Look for cause
??cooling
ICU admisiion
Interestingly, this patient made a full neurologic recovery and was discharged home 2 weeks later. The cause was thought to be primary respiratory arrest, from respiratory failure.