That’s hyperventilating

Wow. The link says her bicarb was 11 – that means she had been hyperventilating so long that she had renal compensation.

In other words, hours to days. I suspect there is more to the story. Either the labs are an exageration (most likely), the pt is psychotic (it’s hard to hyperventilate for hours a time) or she’s on a combination of drugs that screw up the regulation.

Illegal drugs (pt is 16…) are possible. Aspirin is the classic legal drug, but maybe the pt got topamax or diamox?

There may be a renal tubular acidosis as well but something made the pt hyperventilate can cause the (primary) resp acidosis.

Great ABG though.