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Metabolic acidosis in status asthmaticus
Respiration; International Review of Thoracic Diseases
|January 1, 1976
Summary
Severe asthma patients often experience metabolic acidosis, with increased lactic acid possibly linked to muscle glycolysis and hyperventilation. These factors contribute to the complex acid-base disturbances seen in status asthmaticus.
Area of Science:
- Pulmonary Medicine
- Critical Care Medicine
- Biochemistry
Background:
- Status asthmaticus presents complex physiological challenges.
- Acid-base balance disturbances are common in severe asthma exacerbations.
Purpose of the Study:
- To investigate the prevalence and causes of metabolic acidosis in patients with status asthmaticus.
- To explore the role of lactic acid and glycolysis in the observed acid-base changes.
Main Methods:
- Measurement of blood gases and acid-base parameters.
- Analysis of lactic acid (LA) and pyruvic acid (PA) levels.
- Assessment of the lactate to pyruvate ratio (LA/PA).
Main Results:
- Metabolic acidosis was identified in 37.9% of patients with status asthmaticus.
- Increased lactic acid and elevated LA/PA ratios were observed in a significant subset of these patients.
- Base deficit, unexplained by organic acids, suggested a role for hypocapnic hyperventilation.
Conclusions:
- Increased glycolysis and anaerobic muscle metabolism likely contribute to lactic acidosis in severe airway obstruction.
- Hyperventilation may exacerbate hyperlactatemia in severe asthma.
- Understanding these metabolic changes is crucial for managing status asthmaticus.