Metabolism
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Life-threatening acidosis in an alcoholic - and in a hunger striker given intravenous glucose
PC is a 50 year old man, 174 cm tall and weighing 105 kg. He is an engineer, and works on secondment in one of the strict Islamic states in the Gulf, where alcohol is prohibited.
At the beginning of August he returned to England for his annual leave. According to his family, he behaved as he usually did when on home leave, consuming a great deal of alcohol and refusing meals. He was known to be drinking 2 litres of whiskey, two or three bottles of wine, and a dozen or more cans of lager each day; he refused most meals and his solid food consisted mainly of sweets and biscuits.
On September 1st he was admitted to the Emergency Department of University College Hospital, semi-conscious, and with a rapid respiration rate (40 /min). His blood pressure was 90/60 and his pulse rate was 136 /min. His temperature was normal (37.1 °C). Emergency blood gas analysis revealed severe acidosis: pH 7.02 and base excess -23.
(The base excess is the amount of acid required to return blood pH to the normal range of 7.35 - 7.45 - a negative base excess indicates acidosis)