Survival after severe metabolic acidosis (pH=6.66) -

Backround: Metabolic acidosis is an acid-base disturbance, which is characterized by primary consumption of body buffers and causing decreased blood HCO3- level. In this article we discus a case with severe metabolic acidosis (pH=6.66) due to diarrhea that was caused by chemotherapeutic agents. Case: The patient was a male aged 20 and had colon cancer with bone metastase. He started getting chemotherapy three months ago. When he was seen in the emergency service he was unconscious and had convulsion. He had diarrhea in his history. He was intubated and put on the mechanical ventilator after admittance to the ICU. Arteriel blood gas values were pH: 6.66, PaCO2: 102 mmHg, PaO2: 307 mmHg, HCO3: 10.7 mmol L-1, SpO2: %97, BE: -23 mmol L-1 and laktat: 28 mmol L-1. Convulsion were stopped after giving benzodiazepine and barbiturate respectively. Fluid and NaHCO3 replacement were provided. After ten hours arteriel blood gas values were measured as normal and he was extubated. He was transferred to an oncology clinic after observation for 3 days. Result: It should be considered that risk of severe metabolic acidosis and planing early and suitable therapy when developed diarrhea in patients who are used chemotherapy.