Septic and breathing hard

advanced

A 66-year-old with pyelonephritis, BP 84/50, lactate 4.8.

Blood gas

pH7.32

PaCO226 mmHg

HCO313 mmol/L

PaO278 mmHg

Na138 mmol/L

Cl104 mmol/L

K4.4 mmol/L

Lactate4.8 mmol/L

Albumin30 g/L

No high/low cues on purpose: read the numbers the way the gas machine prints them.

Stepwise interpretation

Commit to your own read first: pH, primary process, compensation, gap, delta, oxygenation. Then walk the engine’s steps and see where you agree.