Gas Goblin: Case #26

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The Grey Skin Mystery

A 24-year-old man presents with dizziness and dyspnoea after using amyl nitrite recreationally. He has slate-grey skin and chocolate-coloured blood.

ABG
pH: 7.3 (7.35 – 7.45)
pO₂: 100 mmHg (75 – 100)
pCO₂: 36 mmHg (35 – 45)
HCO₃⁻: 18 mmol/L (22 – 26)
BE: -6 mmol/L (-3 – 3)
SaO₂: 85 % (94 – 100)
Na⁺: 138 mmol/L (135 – 145)
K⁺: 4.1 mmol/L (3.5 – 5.5)
Cl: 102 mmol/L (95 – 110)
Ca: 1.14 mmol/L (1.12 – 1.3)
Lactate: 3 mmol/L
Glucose: 5 mmol/L (4 – 8)
Urea: 6 mmol/L
Creatinine: 75 μmol/L
Osmolarity: 285 mOsm/L
COHb: 1 % (0.2 – 2)
MetHb: 22 %
fiO2: 1

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Parameters

Sample Type ABG

pH

pO₂ (mmHg)

pCO₂ (mmHg)

HCO₃⁻ (mmol/L)

BE (mmol/L)

SaO₂ (%)

Na⁺ (mmol/L)

K⁺ (mmol/L)

Cl (mmol/L)

Ca (mmol/L)

Lactate (mmol/L)

Glucose (mmol/L)

Urea (mmol/L)

Creatinine (μmol/L)

Osmolarity (mOsm/L)

COHb (%)

MetHb (%)

fiO2

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