A Fluid Balancing Act

Author: Girish Boggaram / Editor: Tajek B Hassan / Reviewer: Jon Bailey / Codes: A2Published: 17/01/2022

An 83-year-old female presents with worsening shortness of breath over the past three days which suddenly got worse tonight. She has a cough with whitish mucous expectoration, and no history of chest pain or fever.

She is not known to have COPD, but is known to the renal team and attends hospital three times per week.

She presents with the inability to complete sentences, and is tachypnoeic, tachycardic and hypoxic requiring supplementary oxygen via a high flow face mask.

She has bilateral coarse crepitations on chest examination.

An arterial blood gas shows acidosis, hypoxia, and hypercapnia.

A plain chest radiograph has been performed, which is shown below:

Think about it CIC_0

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