A 49-year old male was rushed to the ER because of sudden loss of consciousness

Question

A 49-year old male was rushed to the ER because of sudden loss of consciousness (well, he was unconscious for 1 day, then his family brought him in). At the ER, he was unresponsive with shallow respiration. He was intubated and mechanically ventilated. The following are results from initial testing, leading to a diagnosis of metabolic acidosis: blood pH HCO3 ammonia liver enzymes (ALT, AST)elevated osmolar ga 6.8 (normal is 7.4 7 mEq (normal is 22-28) elevated elevated at +22 (normal is -10 to +10) After questioning the patient's family, they admitted that he had drank an unknown quantity of homemade wine. It would take another day to run the test for blood MeOH concentration (as this is an uncommon occurrence and therefore tests are not on-site), but the osmolar gap is a quick assay and gives a good indication that there are extra crystalloids in the blood stream. It measures the difference between calculated blood osmolality of the three major crystalloids: Na+, glucose, urea; and actual measured osmolarity of the blood. From a toxicological perspective, these extra crystalloids are usually EtOH, MeOH, methylene glycol, or isopropyl alcohol. The patient was given emergency hemodialysis to get rid of the extra crystalloids.

Explanation / Answer

This is a case of Acute Respiratory acidosis, a medical emergency in which decreased ventilation causes, increased carbon dioxide concentration (PaCO2) and decreased pH of the blood.Carbon dioxide is produced when the body's cells respire and accumulate rapidly in the lungs , when the lungs do not adequately expel it through alveolar ventilation.

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