Gas Goblin: Case #13

A 76-year-old woman with dementia was given 4 L of normal saline for ‘poor urine output’ on the ward and now presents with severe dyspnoea, crackles and hypertension.

• ABG
• pH: 7.28 (7.35 – 7.45)
• pO₂: 60 mmHg (75 – 100)
• pCO₂: 52 mmHg (35 – 45)
• HCO₃⁻: 24 mmol/L (22 – 26)
• BE: -2 mmol/L (-3 – 3)
• SaO₂: 88 % (94 – 100)
• Na⁺: 142 mmol/L (135 – 145)
• K⁺: 4.1 mmol/L (3.5 – 5.5)
• Cl: 118 mmol/L (95 – 110)
• Ca: 1.12 mmol/L (1.12 – 1.3)
• Lactate: 2.2 mmol/L
• Glucose: 7 mmol/L (4 – 8)
• Urea: 9 mmol/L
• Creatinine: 95 μmol/L
• Osmolarity: 300 mOsm/L
• COHb: 1 % (0.2 – 2)
• MetHb: 1 %
• fiO2: 0.4

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