system
Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.
user
A 54-year-old man is brought to the emergency department by his wife because of high fever and confusion for the past 10 hours. His wife reports that 1 week ago during a trip to Guatemala he underwent an emergency appendectomy. His temperature is 40.1°C (104.2°F), pulse is 132/min, and blood pressure is 74/46 mm Hg. He is oriented only to person. Physical examination shows a surgical wound in the right lower quadrant with purulent discharge. The skin is warm and dry. Serum studies show a sodium concentration of 138 mEq/L, potassium concentration of 3.7 mEq/L, and lactate concentration of 3.5 mEq/L (N = 0.5–2.2 mEq/L). Arterial blood gas analysis on room air shows:
pH 7.21
pCO2 36
HCO3- 12
O2 saturation 87%
Which of the following is the most likely explanation for these laboratory changes?"
assistant
Respiratory fatigue