med 610 clinical respiratory diseases & critcare med

Arterial Blood Gas

Case 8

A 47 year-old man with a history of heavy alcohol use presents with a two-day history of severe abdominal pain, nausea and vomiting. On exam, his blood pressure is 90/50 and he is markedly tender in his epigastrum. His initial laboratory studies reveal:

  • sodium of 132
  • chloride 92
  • HCO3- 16
  • creatinine 1.5
  • amylase 400
  • lipase 250

A room air arterial blood gas is drawn and reveals

  • pH 7.28,
  • PCO2 34,
  • PO2 88,
  • HCO3- 16

Acid-base status:

Alveolar-arterial oxygen difference:

Explanation for the clinical picture:

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