Prolonged severe hypercapnia complicating near fatal asthma in a 35-year-old woman.
OBJECTIVE
We describe a patient with a prolonged and severe hypercapnia occurring during an episode of status asthmaticus induced by ophthalmic instillation of carteolol.


METHODS
Prehospital Emergency Medical Service and Pulmonary Intensive Care Unit in a university hospital.


METHODS
A 35-year-old female developed an acute asthma attack while at home, which required advanced life support.


METHODS
On hospital admission, arterial blood gases revealed a PaCO2 of 208 mmHg. Hypercapnia persisted with a PaCO2 of more than 190 mmHg for 10 h, with pH always less than 7.00. The patient was finally discharged after 26 days without sequelae.


CONCLUSIONS
This case illustrates the cerebral and cardiovascular tolerance of severe and prolonged hypercapnia associated with major acidosis.
Adnet
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Department of Anesthesiology, University of Paris VII, France. fadnet@compuserve.com
Plaisance
P
P
Borron
S W
SW
Levy
A
A
Payen
D
D
D000142:Acidosis, Respiratory / Q000150:complications*; D000319:Adrenergic beta-Antagonists / Q000009:adverse effects; D000328:Adult; D002354:Carteolol / Q000009:adverse effects; D005260:Female; D006439:Hemodynamics; D006801:Humans; D006863:Hydrogen-Ion Concentration; D006935:Hypercapnia / Q000150:complications*; D013224:Status Asthmaticus / Q000139:chemically induced / Q000150:complications* / Q000503:physiopathology
D000319:Adrenergic beta-Antagonists; D002354:Carteolol