title: A failed case of weaning from a mechanical ventilator with lorazepam successfully accomplished by ziprasidone.
abstract: Chronic Obstructive Pulmonary Disease (COPD) exacerbations are potential medical emergencies treated with bronchodilators, glucocorticoids and supplemental oxygen. However, in extreme cases, adequate treatment requires mechanical ventilation via endotracheal intubation to correct the acid-base imbalance created by the disease process. We present a case of a 52-year-old female with COPD exacerbation requiring intubation who failed extubation multiple times while concurrently being treated with lorazepam, for agitation. Based on the evidence for increased carbon dioxide retention associated with benzodiazepine use, we weaned the patient off the lorazepam which in turn allowed the patient to be successfully weaned off the ventilator.
authors.affiliation: Eastern Virginia Medical School, Department of Psychiatry and Behavioral Sciences, Norfolk, VA 23507, USA. spiegedr@evms.edu
authors.forename: David R
authors.initials: DR
authors.lastname: Spiegel
authors.forename: Navindra
authors.initials: N
authors.lastname: Ramdath
mesh_terms: D014151:Anti-Anxiety Agents / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008140:Lorazepam / Q000627:therapeutic use*; D008875:Middle Aged; D010879:Piperazines / Q000627:therapeutic use*; D029424:Pulmonary Disease, Chronic Obstructive / Q000628:therapy; D013844:Thiazoles / Q000627:therapeutic use*; D016896:Treatment Outcome; D015300:Ventilator Weaning / Q000379:methods*
chemical_list: D014151:Anti-Anxiety Agents; D014150:Antipsychotic Agents; D010879:Piperazines; D013844:Thiazoles; C092292:ziprasidone; D008140:Lorazepam