Gas Goblin: Case #5

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Goblin
The Collapse at Home

A 64-year-old woman with recent knee replacement collapses at home with sudden pleuritic chest pain, hypotension and tachycardia. She is hypoxic despite high-flow oxygen.

  • ABG
  • pH: 7.2 (7.35 – 7.45)
  • pO₂: 48 mmHg (75 – 100)
  • pCO₂: 55 mmHg (35 – 45)
  • HCO₃⁻: 21 mmol/L (22 – 26)
  • BE: -7 mmol/L (-3 – 3)
  • SaO₂: 82 % (94 – 100)
  • Na⁺: 138 mmol/L (135 – 145)
  • K⁺: 4.7 mmol/L (3.5 – 5.5)
  • Cl: 100 mmol/L (95 – 110)
  • Ca: 1.16 mmol/L (1.12 – 1.3)
  • Lactate: 5 mmol/L
  • Glucose: 7 mmol/L (4 – 8)
  • Urea: 8 mmol/L
  • Creatinine: 95 μmol/L
  • Osmolarity: 295 mOsm/L
  • COHb: 1 % (0.2 – 2)
  • MetHb: 1 %
  • fiO2: 0.6

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