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A proper assessment separates a drive problem from a performance problem.

tachycardia, tachypnoea, altered level of consciousness presence of risk factors features of underlying cause INVESTIGATIONS high anion gap metabolic acidosis (HAGMA) on blood gas normal osmolar gap normal lactate normal beta-hydroxybutyrate high pyroglutamic acid (urine or blood) MANAGEMENT stop exacerbating factors treat sepsis, including: early and appropriate antibiotics source control supportive care and monitoring intubation, ventilation, renal replacement therapy (RRT) as indicated N-acetylcysteine help replenish glutathione stores References and Links LITFL Metabolic Muddle 004 Staph sepsis and an unusual metabolic acidosis Journal articles Dempsey GA, Lyall HJ, Corke CF, & Scheinkestel CD (2000)

Its also reasonable if your Triglycerides are elevated and you want an adjunct to diet and omega-3

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Ondrej, M