WBC 19, Lactic Acid 3.2, but not septic? - page 2
by Turtle in scrubs 5,624 Views | 11 Comments
My patient came into the hospital with hypotension and r/o sepsis. SBP 69, WBC 19, Lactic Acid 3.2, HR 90's in chronic Afib, RR 20, afebrile. There did not appear to be any infection. She has a cocktail of PMH including CHF,... Read More
- 0Apr 13, '10 by Turtle in scrubsQuote from meandragonbrettWas your patient receiving LR as IVF?
WBC of 19 doesn't really tell us anything. What we need to know is the diff on the WBC.
Lactate was probably slightly elevated secondary to the hypotension and anaerobic metabolism that results.
Not sure how much fluid she got initially. I picked her up a day later and she was on 75 cc NS/hr, that was turned off probably after she was there 24 hours and a day before she went home.
So the diff would tell us likely reasons for the elevation in WBC, and I haven't been paying attention to the diff... looks like this is an area for improvement.
So if it were infection we would be looking for an elevation in neutrophils, lymphocytes, or monocytes... sound right? What about a stress reaction .. what would be elevated then?