| Popis: |
A 70-year-old Italian man presented to our emergency department for dyspnea and confusion. He was affected by diabetes mellitus type 2, but he stopped his medication 10 years before. At admission, his vital signs were blood pressure of 60/50 mmHg, heart rate of 130 bpm, peripheral oxygen saturation of 94% in the Venturi Mask FiO2 40%, respiratory rate of 40/min, and body temperature of 36°C. Physical examination revealed hypoperfusion with a high Mottling Score and dark stools with a positive hydrogen peroxide reaction. He denied abdominal pain, nausea, and vomiting. Laboratory findings showed leucocytosis (White Blood Cells, WBC, 31,580/mm3; N 91.6%), Hemoglobin (Hb) 14.5 g/dL, Hematocrit Test (Hct) 49%, hyperglycaemia (>700 mg/L), and normal coagulation time. Arterial blood gas documented a metabolic acidosis with pH 6.95, Partial Pressure of Carbon Dioxide (pCO2) 27.5 mmHg, HCO3 7.1 mmol/L, lactate 8.14 mmol/L (normal value |
