Gas Goblin: Case #2
The Breathless Balancing Act
A 78-year-old man with known COPD, chronic kidney disease and heart failure on frusemide presents with worsening dyspnoea, orthopnoea and leg swelling. He is on home oxygen.
- ABG
- pH: 7.37 (7.35 – 7.45)
- pO₂: 55 mmHg (75 – 100)
- pCO₂: 60 mmHg (35 – 45)
- HCO₃⁻: 34 mmol/L (22 – 26)
- BE: 8 mmol/L (-3 – 3)
- SaO₂: 88 % (94 – 100)
- Na⁺: 140 mmol/L (135 – 145)
- K⁺: 4.8 mmol/L (3.5 – 5.5)
- Cl: 90 mmol/L (95 – 110)
- Ca: 1.12 mmol/L (1.12 – 1.3)
- Lactate: 3 mmol/L
- Glucose: 7.5 mmol/L (4 – 8)
- Urea: 25 mmol/L
- Creatinine: 250 μmol/L
- Osmolarity: 305 mOsm/L
- COHb: 1 % (0.2 – 2)
- MetHb: 1 %
- fiO2: 0.28
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