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Volume 346:1253-1254 April 18, 2002 Number 16
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Severe Hyperosmolar Metabolic Acidosis Due to a Large Dose of Intravenous Lorazepam

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To the Editor: In a 34-year-old woman with a history of alcohol abuse, cardiomyopathy, and AIDS, acute respiratory failure developed as a result of Escherichia coli sepsis and pneumonia. Initial laboratory studies revealed a pH of 7.2, a bicarbonate level of 8.8 mmol per liter, a partial pressure of carbon dioxide of 26 mm Hg, an anion gap of 15.4 mmol per liter, a lactate level of 6.9 mmol per liter, and a creatinine level of 1.8 mg per deciliter, with a normal blood sugar level and no ketones.

After four days of treatment, the patient's acidosis was worse (pH, . . . [Full Text of this Article]

References


Related Letters:

Hyperosmolar Metabolic Acidosis and Intravenous Lorazepam
Mullins M. E., Barnes B. J., Tayar J., Saggi S. J.
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N Engl J Med 2002; 347:857-858, Sep 12, 2002. Correspondence

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