A 64-year-old man with multilobar pneumonia and sepsis presents with hypoxemic respiratory failure requiring intubation. Vital signs: BP 92/58, HR 118, RR 32, Temp 39.2°C, SpO2 88%. Arterial blood gas shows pH 7.36, PaCO2 20 mm Hg, HCO3− 11 mEq/L. Serum lactate is 8.2 mg/dL (markedly elevated); creatinine is normal. He denies recent medication use. Which acid-base disturbance best characterizes his current status?
- A)Mixed respiratory alkalosis and metabolic acidosisGABARITO
- B)Mixed respiratory acidosis and metabolic acidosis
- C)Pure metabolic alkalosis
- D)Pure respiratory alkalosis
- E)Pure metabolic acidosis with appropriate compensation
Explicação
Sepsis commonly produces lactic acidosis, causing a metabolic acidosis, and can simultaneously trigger marked hyperventilation, causing respiratory alkalosis. The bicarbonate is very low, and the PaCO2 is lower than predicted by Winter formula, indicating a mi... Ver explicação completa e trilha adaptativa →