47/M b/b relatives in unconcious, gasping condition with h/o breathing difficulty since 2-3 days, fever since 3 days K/C/O HTN/CKD O/e unconcious Pupils-b/l 2 mm sluggish reacting Hr-155 BP-60 sbp Spo2- 45% Chest-b/l crepts+ Patient was intubated and put on ventilatory support Norad/dopa infusion started Broad spectrum antibiotics were started LABS- tlc-23000, hb-9.2, urea-234,creat.6.8, Further management?




Respiratory Acidosis +Metabolic Acidosis, hypoximia, lactic Acidosis, LRTI, Septicemia and Septic Shock. Mechanical ventilation, iv RL and NS 1: 1 2 Lit bolus stat and sos, then continue 6 hrly, Noradrenaline infusion continue, Broadspectrum Antibiotics, maintain PH and Electrolytes balance, correct Anaemia, dialysis, start proper antibiotics after blood CS report comes in hand.

respiratory acidosis?? or metabolic acidosis with compensation?

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Hypotension and shock, bilateral pneumonia, severe metabolic acidosis with respiratory acidosis lactic acidosis, hypoxia with co2 retention

check blood sugar level.along with above said medication start hydrocortisone


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