Specimen Name Result Units Range
Plasma Sodium 134 mmol/L (135-145)
Potassium 3.0 mmol/L (3.5-5.5)
Chloride 96 mmol/L (100-109)
Bicarbonate 31 mmol/L (22-32)
Glucose 5.0 mmol/L (3.8-5.5)
Urea 10.0 mmol/L (2.7-7.2)
Creatinine 120 μmol/L (60-110)
Albumin 34 g/L (34-48)
Blood Hb 96 g/L (130-180)
Platelets 129 x109/L (150-450)
WCC 18.0 x109/L (4.0-11.0)
ABG pH 7.48 (7.36-7.44)
PaO2 108 mmHg (70-100)
PaCO2 45 mmHg (35-45)
HCO3- 30 mmol/L (21-26)

Young patient admitted previous day with major trauma 2° MVA.
Post-Massive Transfusion
  • Hypokalaemic metabolic alkalosis (citrate metabolism)
  • Normal respiratory compensation
  • Persistent mild anaemia/thrombocytopenia
  • Raised WCC (neutrophilia)
  • PO2 + 1.25*PCO2 ≈ 164 : on supplemental O2

 

Hypokalaemic Metabolic Alkalosis
Diuretics (esp. loop agents) - low Na+, Cl- / high urea
Mineralocorticoid excess - normal-high Na+, Cl- / normal urea
Vomiting / Gastric outlet obs. - very low Cl- / low-normal Na+ / high urea
Diarrhoea / laxatives - low Cl- / normal Na+ / high urea
Post massive blood Tx - citrate metabolism & acidosis correction