Cardiorespiratory arrest in a patient with advanced diabetic autonomic neuropathy.
A 53-year-old diabetic woman who had been diabetic for 14 years had recurrent episodes of cardiorespiratory arrest, which were easily resuscitated by a few chest massages. In 2 of 4 episodes a radial pulse was detected, so respiratory arrest was thought to be a primary event. Pentazocine was injected several hours prior to each of the 3 episodes. This was considered to be a precipitating factor. From the first episode of cardiorespiratory arrest, she received oxygen inhalation. When oxygen inhalation was withdrawn for 5-10 min, she became cyanotic. This was considered to be a sign of lack of hypoxic drive mediated by peripheral chemoreceptors. Ventilatory responses to hypercapnia was markedly decreased, indicating impaired central chemosensitivity. The possibility that impaired chemosensitivity could be a cause of respiratory arrest was suggested.
D001342:Autonomic Nervous System Diseases / Q000150:complications* / Q000503:physiopathology; D002628:Chemoreceptor Cells / Q000503:physiopathology; D003929:Diabetic Neuropathies / Q000150:complications* / Q000503:physiopathology; D005260:Female; D006323:Heart Arrest / Q000209:etiology*; D006801:Humans; D006935:Hypercapnia / Q000503:physiopathology; D000860:Hypoxia / Q000503:physiopathology; D008875:Middle Aged; D010423:Pentazocine / Q000009:adverse effects
D010423:Pentazocine