05 September 2023: Articles
Severe Ketoacidosis After One Anastomosis Gastric Bypass Surgery
Unusual clinical course, Challenging differential diagnosis, Diagnostic / therapeutic accidents, Management of emergency care, Clinical situation which can not be reproduced for ethical reasons
Nadav Nevo B* , Giuseppe Evola E , Carlo Sagnelli E , Niv Pencovich B , Gabriele Carbone E , Corrado Rispoli BDOI: 10.12659/AJCR.939581
Am J Case Rep 2023; 24:e939581
Table 1. Blood gas analysis during postoperative days 2 to 5. Note the marked metabolic acidosis and the gradual restitution to normal pH after initiation glucose and insulin therapy.
| POD2 | +4 h | +8 h | +12 h | +16 h | +20 h | +24 h | +48 h | +72 h | |
|---|---|---|---|---|---|---|---|---|---|
| pH | 7.105 | 7.153 | 7.208 | 7.223 | 7.267 | 7.29 | 7.35 | 7.39 | 7.404 |
| PCO2 (mmHg) | 22.7 | 22.9 | 29.7 | 24.6 | 26.6 | 28.6 | 29.7 | 34 | 39.5 |
| HCO3 (mmol/L) | 7 | 7.9 | 11.6 | 9.9 | 11.9 | 13.7 | 16.1 | 20.2 | 24 |
| sO2 (%) | 97 | 96 | 95 | 96 | 94 | 95 | 94 | 97 | 96 |
| Base excess (mosmol/L) | −22 | −20.9 | −16.4 | −17.8 | −15.1 | −12.7 | −9.5 | −4.8 | −0.6 |
| Glucose (mg/dL) | 186 | 159 | 181 | 96 | 150 | 185 | 177 | 190 | 185 |
| Sodium (mmol/L) | 130 | 135 | 135 | 137 | 139 | 136 | 139 | 139 | 139 |
| Potassium (mmol/L) | 4.58 | 4.28 | 4.05 | 3.91 | 3.33 | 4.61 | 4.70 | 4.46 | 4.33 |