April 2021 Critical Care Case of the Month: Abnormal Acid-Base Balance in a Post-Partum Woman

• Main Author: Mohammad Abdelaziz Mahmoud
• Format: Article
• Language: English
• Published: Arizona Thoracic Society 2021-04-01
• Series: Southwest Journal of Pulmonary and Critical Care
• Subjects: acidosis; metabolic acidosis; acid base balance; breast feeding; shortness of breath; anion gap; post-partum; mudpiles; ketones; starvation ketosis
• Online Access: https://www.swjpcc.com/critical-care/2021/4/1/april-2021-critical-care-case-of-the-month-abnormal-acid-bas.html

No abstract available. Article truncated after first page. History of Present Illness: A 29-year-old healthy woman, who is 8 weeks postpartum, presented to the emergency department with severe shortness of breath, fast shallow breathing, nausea, several episodes of nonbloody nonbilious emesis, abdominal pain and malaise for 1 week. The patient delivered a healthy boy at full-term by spontaneous vaginal delivery. Her pregnancy was uneventful. She denied smoking or use of alcohol. Physical Exam: On presentation to the emergency department her blood pressure was found to be 121/71, temperature 36.8°C, pulse 110 beats per minute, respiratory rate 20 breaths per minute and SpO2 saturation of 99% while breathing ambient air. Physical exam was remarkable except for dry mucous membranes, sinus tachycardia, and tachypnea with mild epigastric tenderness with light palpation. Which of the following should be done? 1. Complete blood count (CBC) 2. Metabolic panel 3. Chest x-ray 4. Arterial blood gases (ABGs) 5. All of the above …