Reading File
analyse_media
Finding Sources
Venous blood gas report (Radiometer ABL800 Flex, 11/7/2026, 08:45). The analyzer did not report pCO₂ or pO₂, so you can't classify the acidosis from this printout.
The analyzer image upload failed, so I read the printout directly from the photo.
Validity
- pCO₂, pO₂ and the derived values (HCO₃⁻, base excess, anion gap) were not reported. The notes show error 0210 (calibration errors present) for pCO₂ and pO₂, and error 0476 (measurement unstable) for pH.
- Treat the pH of 7.266 as provisional. Don't base treatment on this printout alone.
- The sO₂ of 14% (FHHb 84.8%) is unusually low for a venous sample. It is probably an artefact of the failed pO₂ module or a poor sample. If it is real, it means very poor perfusion or tissue extraction. Check this against the patient's clinical state.
Findings
| Parameter | Result | Comment |
|---|---|---|
| pH | 7.266 (ref 7.35-7.45) | Acidaemia. The type is unknown without pCO₂. |
| ctHb | 11.8 g/dL | Mild anaemia |
| Na⁺ / K⁺ | 140 / 3.7 mmol/L | Normal |
| Cl⁻ | 107 mmol/L | Slightly high |
| iCa²⁺ | 0.97 mmol/L | Low (ref 1.15-1.29) |
| Glucose | 276 mg/dL | Hyperglycaemia |
| Lactate | 1.2 mmol/L | Normal, so lactic acidosis is unlikely |
| Osmolality (calculated) | 295.7 mmol/kg | Normal |
| COHb / MetHb | 0.8% / 0.6% | Normal |
What this could mean
- Acidaemia with glucose 276 and normal lactate: if the patient is diabetic or unwell, consider early diabetic ketoacidosis or another ketoacidosis. Tintinalli's recommends serum beta-hydroxybutyrate, a venous blood gas, electrolytes and lactate in the initial work-up of this picture (Tintinalli's Emergency Medicine, Laboratory Evaluation).
- Respiratory acidosis: hypoventilation, for example from COPD, sedation or a neuromuscular cause, would also lower pH. Only the pCO₂ can tell you.
- Other metabolic causes: renal failure, diarrhoea, or toxins. The slightly high chloride fits a mild non-gap component, but the anion gap can't be calculated without bicarbonate.
- Low ionized calcium: acidosis normally raises ionized calcium, so a low value despite acidaemia is notable. Look for hypoalbuminaemia, pancreatitis, citrate (transfusion), renal disease or hypoparathyroidism. Correct it only if the patient has symptoms or ECG changes, and correct the acidosis and glucose first.
Suggested next steps
- Repeat the gas on a fresh sample, or run it after a calibration check. Draw a fresh syringe with no air bubbles and analyze it promptly.
- Send a serum bicarbonate or total CO₂, then calculate the anion gap.
- Check blood or urine ketones (beta-hydroxybutyrate).
- Assess the patient clinically: respiratory rate and effort, sensorium, perfusion, hydration, and glucose history.
- Check creatinine and urea, and repeat serum calcium with albumin.
I can interpret it more precisely if you tell me the clinical context (age, diabetes, symptoms, oxygen or ventilation status). A repeat gas with pCO₂ and HCO₃⁻ would let me work out compensation and the anion gap.
I didn't run the PubMed check for recent contradicting evidence. This is basic acid-base interpretation, and I haven't searched for any updates.
This is a shared conversation. Sign in to Orris to start your own chat.