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Prolonged severe hypercapnia complicating near fatal asthma in a 35-year-old woman
F Adnet1, P Plaisance, S W Borron
1Department of Anesthesiology, University of Paris VII, France. fadnet@compuserve.com
Objective:
We describe a patient with a prolonged and severe hypercapnia occurring during an episode of status asthmaticus induced by ophthalmic instillation of carteolol.
Setting:
Prehospital Emergency Medical Service and Pulmonary Intensive Care Unit in a university hospital.
Patient:
A 35-year-old female developed an acute asthma attack while at home, which required advanced life support.
Intervention:
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.
Conclusion:
This case illustrates the cerebral and cardiovascular tolerance of severe and prolonged hypercapnia associated with major acidosis.