Scenario Review
8 hours later Mrs Williams’ urine output has picked up to 40-50 ml/hour. She remains confused but her temperature has come down to 37.4°C. Her renal function and arterial blood gases are repeated:
- sodium 142 mmol/L
- potassium 4.9 mmol/L
- urea 20 mmol/L
- creatinine 220 µmol/L
ABGs on room air:
- PO2 10.5 kPa
- pCO2 4.0 kPa
- pH 7.33
- HCO3 18 mEq/L
- Base excess -4
Over the next 4 days Mrs Williams continues to get better. Her kidney function improves to a creatinine of 105 giving her an eGFR of 47 ml/min. The urine and blood cultures both grow E. coli sensitive to tazosin and amoxicillin and on day 4 she is converted to oral antibiotics which she continues for another 6 days on microbiology advice.
Although her acute confusion improves, she does not return to her normal baseline and she is referred to the dementia team for further assessment and on-going management.
She is eventually discharged home with a new diagnosis of vascular dementia