Mr. B is a 70 year old man who developed sub sternal chest pain radiating down his left arm while at home. He was taken to ER via ambulance. His breathing was labored, pulses rapid and weak, and his skin was cold and clammy. An ECG was done which revealed significant “Q” waves in most leads.  Troponin level was elevated. Arterial blood was drawn with the following results: Ph 7.22, PCO2 30 mm, Hg pO2 70 mm, Hg O2 88, HCO3 22 men/liter. Aside from the obvious diagnosis of MI, what is Mr. B’s acid base status and what is caused this disturbance?

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