Gas Goblin: Case #11

A 24-year-old woman with type 1 diabetes presents with abdominal pain, polyuria, Kussmaul respirations and fruity breath after missing several insulin doses.

• VBG
• pH: 7.12 (7.35 – 7.45)
• pO₂: 21 mmHg (75 – 100)
• pCO₂: 25 mmHg (35 – 45)
• HCO₃⁻: 8 mmol/L (22 – 26)
• BE: -18 mmol/L (-3 – 3)
• SaO₂: 99 % (94 – 100)
• Na⁺: 128 mmol/L (135 – 145)
• K⁺: 5.5 mmol/L (3.5 – 5.5)
• Cl: 96 mmol/L (95 – 110)
• Ca: 1.16 mmol/L (1.12 – 1.3)
• Lactate: 3 mmol/L
• Glucose: 28 mmol/L (4 – 8)
• Urea: 7 mmol/L
• Creatinine: 90 μmol/L
• Osmolarity: 310 mOsm/L
• COHb: 1 % (0.2 – 2)
• MetHb: 1 %
• fiO2: 0.21

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