Gas Goblin: Case #8
The Silent Chest Returns
A 22-year-old woman with brittle asthma presents in severe distress. She has had continuous salbutamol nebulisers and is now tiring with a silent chest and hypotension.
- ABG
- pH: 7.1 (7.35 – 7.45)
- pO₂: 55 mmHg (75 – 100)
- pCO₂: 70 mmHg (35 – 45)
- HCO₃⁻: 21 mmol/L (22 – 26)
- BE: -8 mmol/L (-3 – 3)
- SaO₂: 88 % (94 – 100)
- Na⁺: 138 mmol/L (135 – 145)
- K⁺: 4.3 mmol/L (3.5 – 5.5)
- Cl: 102 mmol/L (95 – 110)
- Ca: 1.18 mmol/L (1.12 – 1.3)
- Lactate: 6 mmol/L
- Glucose: 9.5 mmol/L (4 – 8)
- Urea: 6 mmol/L
- Creatinine: 80 μmol/L
- Osmolarity: 295 mOsm/L
- COHb: 1 % (0.2 – 2)
- MetHb: 1 %
- fiO2: 0.6
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