Table 2

Serial blood gas analyses and key management process

Normal range0h, arterial blood on room air2h, arterial blood on room air4h, arterial blood on NPO2 2 L·min−18h, venous blood on room air24h, venous blood on room air
HCO3, mmol·L−122.0–
BE, mEq·L−1−2.0–2.0−5.1−14.1−9.0−6.3−4.7
Lactate, mmol·L−10.50–2.204.408.213.902.002.50
Anion gap, mmol·L−14.0–
Plan of actionNebulised salbutamol 5 mg
Nebulised salbutamol 5 mg + ipratropium 0.25 mg
Followed by MDI salbutamol 200 μg hourly ×6
Intravenous bolus 500 mL 0.9% saline
Intravenous ceftriaxone 2 g immediately and once daily
Intravenous 2 L·day−1 HS+40 mL 8.4% NaHCO3
Off MDI salbutamol
Intravenous 2 L·day−1 0.9% saline
Started on MART (budesonide/formoterol)
Off intravenous fluid

NPO2: nasal prong oxygen; BE: base excess; HS: half saline; MART: maintenance and reliever therapy.