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To the Editor: In a 34-year-old woman with a history of alcohol abuse, cardiomyopathy, and AIDS, acute respiratory failure developed as a result of Escherichia coli sepsis and pneumonia. Initial laboratory studies revealed a pH of 7.2, a bicarbonate level of 8.8 mmol per liter, a partial pressure of carbon dioxide of 26 mm Hg, an anion gap of 15.4 mmol per liter, a lactate level of 6.9 mmol per liter, and a creatinine level of 1.8 mg per deciliter, with a normal blood sugar level and no ketones. After four days of treatment, the patient's acidosis was worse (pH, . . .

Severe Hyperosmolar Metabolic Acidosis Due to a Large Dose of Intravenous Lorazepam