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Extreme metabolic acidosis
Author(s) -
Sjøgren P.,
Andersen L. W.
Publication year - 1987
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.1987.tb02620.x
Subject(s) - medicine , sodium bicarbonate , metabolic acidosis , acidosis , diabetes mellitus , lactic acidosis , insulin , perfusion , isotonic , bicarbonate , metabolic disorder , endocrinology , anesthesia , chemistry
A 42‐year‐old male patient, who suffered from insulin‐dependent diabetes mellitus (IDDM) and intolerance of laetose, presented with extreme metabolic acidosis (lactic acidosis). On arrival, an arterial blood sample showed: pH 6.79, Po 2 18.8 kPa, Pco 2 0.9 kPa, base excess ‐ 33 mmol I‐ 1 , blood glucose 38 mmol I‐ 1 and oesophageal temperature 30°C. Apart from the uncontrolled hyperglycaemia, a fluid balance disorder elicited by diarrhoea and disturbed tissue perfusion were possible aetiological factors. The patient was treated with a low‐dose insulin regimen and infusion of isotonic sodium bicarbonate with a satisfactory result.