Extreme metabolic acidosis. Case report.
A 42-year-old male patient, who suffered from insulin-dependent diabetes mellitus (IDDM) and intolerance of lactose, presented with extreme metabolic acidosis (lactic acidosis). On arrival, an arterial blood sample showed: pH 6.79, PO2 18.8 kPa, PCO2 0.9 kPa, base excess-33 mmol l-1, blood glucose 38 mmol l-1 and oesophageal temperature 30 degrees 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.
Sjøgren
P
P
Andersen
L W
LW
D000138:Acidosis / Q000209:etiology / Q000378:metabolism*; D000328:Adult; D001784:Blood Gas Analysis; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D006801:Humans; D007328:Insulin / Q000627:therapeutic use; D008297:Male
D007328:Insulin