A 60-year-old man was presented at the ICU after he was found with impaired consciousness at his home. He had a history of alcohol abuse, and several unlabelled cans with unknown contents were discovered at his home. The patient was declared to have a Glasgow Coma Scale score of 3 with equal, round pupils that were not reactive to light.
He had a rectal temperature of 32.7°C and cool, pale skin. Physical examination Respiration rate: 40–50 breaths/min Blood pressure: 144/60 mmHg Heart rate: 77 beats per minute His electrocardiogram image has been provided. Laboratory Analysis Blood gas analysis pH: 6.77 (7.37–7.45) pCO 2: 5 kPa (4.7–6.0 kPa) Bicarbonate: 2.0 mmol/L (22–27 mmol/L) Base excess: 30 mmol/L (0 ± 3) Serum potassium: 7.4 mmol/L (5–5.0 mmol/L) Lactate blood: High above measurable range (<2 mmol/L) Lactate plasma: 3.8 mmol/L (<2 mmol/L) Anion gap: 41 mmol/L (3–9 mmol/L)…
