Acidosis Case Study

Ms. Blake’s blood pH is 7.30, which is lower than the low end of the normal blood pH range of 7.35. This means that her blood is slightly more acidic than normal (Patel, Mehta, Chauhan, & Solaki, 2014). The partial pressure of carbon dioxide is 40 mmHg which is within the normal range of 35-45 mmHg (Patel, Mehta, Chauhan, & Solaki, 2014). This means that her acidosis is not caused by an inability for the body to expel carbon dioxide. However, the partial pressure of oxygen is 70 mmHg, which is below the normal range of 80 – 100 mmHg. This means that Ms. Blake does not have enough oxygen in her bloodstream which can also cause deep vein thrombosis. Her bicarbonate is 20 mEq/L which is slightly below the normal range of 22-28 mEq/L which indicates metabolic acidosis. While there are many different causes of metabolic acidosis, in this case, it is caused by the ketones made by having high blood glucose (Patel, Mehta, Chauhan, & Solaki, 2014). This leads to increased free hydrogen ions in the body, which leads to the increased pH observed in the blood. 

Her anion gap is 25 mEq/L, which is abnormal. The normal range for an anion gap is 3-11 mEq/L, thus an anion gap of 25 mEq/L is fairly high (Lu et al, 2011). Her anion gap is high because her body is producing more free hydrogen atoms than is otherwise needed or is able to regulate. The result is that any free bicarbonate ions within the body are being used to buffer the pH of the bloodstream and bind to the free hydrogens to decrease the pH of the blood (Lu et al, 2011). Thus, there are fewer bicarbonate ions in the blood, resulting in a high anion gap.  

Thus, it is likely that Ms. Blake is experiencing the early signs of diabetic Ketoacidosis. It is important to treat the condition by lowering her blood sugar levels so that her body stops producing the ketones, which are contributing to having free hydrogens in the bloodstream.

References

Lu, J., Zello, G. A., Randell, E., Adeli, K., Krahn, J., & Meng, Q. H. (2011). Closing the anion gap: Contribution of D-lactate to diabetic ketoacidosis. Clinica Chimica Acta, 412(3), 286-291.

Patel, P. J., Mehta, N., Chauhan, S., & Solanki, P. (2014). Arterial blood gas analysis in chronic obstructive pulmonary disease cases. Natl J Integr Res Med, 5(1), 10-12.