PT  - JOURNAL ARTICLE
AU  - Nicola Di Rollo
AU  - David Caesar
AU  - David A Ferenbach
AU  - Mark J G Dunn
TI  - Survival from profound metabolic acidosis due to hypovolaemic shock. A world record?
AID  - 10.1136/bcr-2012-008315
DP  - 2013 Jan 30
TA  - BMJ Case Reports
PG  - bcr2012008315
VI  - 2013
4099  - http://casereports.bmj.com/content/2013/bcr-2012-008315.short
4100  - http://casereports.bmj.com/content/2013/bcr-2012-008315.full
AB  - This case describes the unexpected survival of an adult man who presented to the emergency department with hypovolaemic shock secondary to a splenic haemorrhage. Before surgery he had a pH 6.527, base excess (BE) −34.2 mmol/l and lactate 15.6 mmol/l. He underwent a splenectomy after which his condition stabilised. He was managed in the intensive care unit postoperatively where he required organ support including renal replacement therapy but was subsequently discharged home with no neurological or renal deficit. Although there are case reports of patients surviving such profound metabolic acidosis these have mainly been cases of near drowning or toxic alcohol ingestion. To the best of our knowledge this is the first reported case of survival after a pH of 6.5 secondary to hypovolaemic shock.