Gas Goblin: Case #6

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Goblin
The Silent Gurgle Turns Sour

A 70-year-old woman with small bowel obstruction has had several days of profuse vomiting and now develops fever, hypoxia and coarse crackles after an aspiration event.

  • ABG
  • pH: 7.38 (7.35 – 7.45)
  • pO₂: 68 mmHg (75 – 100)
  • pCO₂: 58 mmHg (35 – 45)
  • HCO₃⁻: 34 mmol/L (22 – 26)
  • BE: 8 mmol/L (-3 – 3)
  • SaO₂: 92 % (94 – 100)
  • Na⁺: 132 mmol/L (135 – 145)
  • K⁺: 2.9 mmol/L (3.5 – 5.5)
  • Cl: 86 mmol/L (95 – 110)
  • Ca: 1.14 mmol/L (1.12 – 1.3)
  • Lactate: 2 mmol/L
  • Glucose: 6 mmol/L (4 – 8)
  • Urea: 9 mmol/L
  • Creatinine: 110 μmol/L
  • Osmolarity: 290 mOsm/L
  • COHb: 1 % (0.2 – 2)
  • MetHb: 1 %
  • fiO2: 0.4

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