A 50 year – old gentleman with past medical history of a peptic ulcer disease that treated himself with alkalis (calcium carbonate, milk, almagate and aluminium hydroxide) is brought to A&E with complaints of severe vomiting and weakness. A room air arterial blood gas revealed the following results:
pH 7.44
PaCO2 6.6 kPa (50 mmHg)
PaO2 8.7 kPa (66 mmHg)
HCO3 35 mmol/l
Na 139 mm0l/l
K 4.5 mmol/l
Cl 95 mmol/l
Ca 3 mmol/l (12 mg/dl)
What is the acid – base disturbance?: