A 46-year-o ld male presents with vomiting for the past five days.
His arterial blood gas result on room air is shown below:
Parameter |
Patient Value |
Adult Normal Range |
|
pH |
7.74* |
7.35 -7.45 |
|
pCO2 |
48.5 mmHg (6.4 kPa)* |
35.0 -45.0 (4.6 - 6.0) |
|
pO2 |
80 mmHg (10.5 kPa) |
80 - 100 (10.5 -13.0} |
|
Bicarbonate |
62 mmol/L* |
20- 30 |
|
Base Excess |
39.6 mmol/L* |
-2.0 - +2.0 |
|
SpO2 |
97.6% |
95.0 -98.0 |
|
Sodium |
131 mmol/L* |
135 - 145 |
|
Potassium |
3.1 mmol/L* |
3.5 - 5.0 |
|
Chloride |
47 mmol/L* |
95 - 105 |
|
Glucose |
10.5 mmol/L* |
3.5 - 6.0 |
|
Lactate |
5.6 mmol/L* |
< 2.0 |
Describe the acid-base derangements seen (30% marks)
Let us dissect this systematically: