Gas Goblin: Case #7
The Breath That Wouldn’t Settle
A 72-year-old man with severe COPD on home oxygen presents with increasing dyspnoea. He has been given repeated salbutamol and nebulised ipratropium and is on IV frusemide for suspected CCF.
- ABG
- pH: 7.3 (7.35 – 7.45)
- pO₂: 50 mmHg (75 – 100)
- pCO₂: 75 mmHg (35 – 45)
- HCO₃⁻: 34 mmol/L (22 – 26)
- BE: 5 mmol/L (-3 – 3)
- SaO₂: 86 % (94 – 100)
- Na⁺: 140 mmol/L (135 – 145)
- K⁺: 4.2 mmol/L (3.5 – 5.5)
- Cl: 90 mmol/L (95 – 110)
- Ca: 1.12 mmol/L (1.12 – 1.3)
- Lactate: 4 mmol/L
- Glucose: 8 mmol/L (4 – 8)
- Urea: 14 mmol/L
- Creatinine: 150 μmol/L
- Osmolarity: 300 mOsm/L
- COHb: 1 % (0.2 – 2)
- MetHb: 1 %
- fiO2: 0.32
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