44 year old presents by ambulance with altered conscious state...
PMx - Alcoholic liver disease, sepsis, ischaemic hepatitis
+ Describe the Blood Gas
- Severe, life threatening metabolic alkalosis
- Concurrent respiratory alkalosis (CO2 lower than expected)
- Severe hypokalaemia
- Severe hyponatraemia
Expected pCO2 = 0.7 [HCO3] + 20 mmHg (range: +/- 5)
In this case it would be expected to be 59.9mmHg.
+ What are the potential causes of metabolic alkaosis?
- Addition of Base to ECF
- Chloride Depletion (Loss of gastric acid (vomiting, NG drainage) and diuretic use account for 90% of clinical cases of metabolic alkalosis)
- Potassium depletion
- Laxative abuse
- Severe hypoalbumiaemia
Source - AnaesthesiaMCQ.com