Pregnant and Acidotic
A pregnant patient has pneumonia. There are also concerns that she has a metabolic acidosis. Can you solve this metabolic muddle?
Category CCC
The LITFL Critical Care Compendium is a comprehensive collection of pages concisely covering the core topics and controversies of critical care.
CATMUDPILES
76 year old male living alone. Found obtunded at home by neighbours. Breathing rapidly and muttering incoherently. No other history available. CATMUDPILES?
Unlearning
Unlearning is the process of abandoning or giving up knowledge, values or behaviour either unconsciously or deliberately
Pyroglutamic Acidosis
Pyroglutamic acidosis is a rare cause of high anion gap metabolic acidosis (HAGMA). When glutathione levels are low, the activity of γ-glutamyl cyclotransferase is increased, resulting in pyroglutamic acid accumulation in glutathione-depleted states
D-Lactic acidosis
D-Lactic acidosis aka D-lactic encephalopathy. Rare cause of high anion gap metabolic acidosis (HAGMA), typically occurs in patients short bowel syndrome or following jejuno-ileal bypass surgery
ABG changes in Cardiac Arrest and CPR
The degree of acid-base abnormality during cardiac arrest and cardio-pulmonary resuscitation (CPR) is dependent on a number of variables
Arterial Blood Gas in Hypothermia
Arterial Blood Gas in Hypothermia. The solubility of oxygen and carbon dioxide is increased at low temperatures.
Bimanual laryngoscopy
Bimanual laryngoscopy using external laryngeal manipulation (ELM) is the single most practical and effective airway management technique for facilitating intubation during direct laryngoscopy.
You can beat the feeling
It’s a busy night shift in the ED (as always) and one of the Interns comes to present a case to you. He’s seen a 23 yr old female who has presented with lethargy and weakness. While you're listening to the Intern your phone rings — it's the lab calling to tell you the patient’s potassium is 1.9 mmol/L.
Hypernatraemia and Acidosis
A 20 year old male presents with 3 days of lethargy and generalised malaise. He is confused and looks very unwell. Can sort out this metabolic muddle?
Staph Sepsis Acidosis
You are asked to review a 73 year old lady who is in hospital for treatment of septic arthritis affecting a prosthetic right hip joint inserted 5 years earlier.
Metabolic Mayhem a Headache
An 87 year old female presented with a subarachnoid haemorrhage. GCS 8/15. Can you figure out her acid-base disturbance?