An under-recognized complication of treatment of acute severe asthma

Creagh-Brown, Ben C. and Ball, J. (2008) An under-recognized complication of treatment of acute severe asthma American Journal of Emergency Medicine, 26 (4). 514.e1-514.e3.

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Abstract

A 39-year-old man presented to the emergency department (ED) in severe respiratory distress. He had a prior diagnosis of brittle asthma and had been admitted on several occasions but never previously ventilated. Therapy given in the first 3 hours of arrival included nebulized salbutamol (5 mg, ×5), ipratropium bromide (0.5 mg), intravenous hydrocortisone (200 mg), and magnesium sulfate (2 g). His arterial blood gases continued to deteriorate. He was then given an intravenous bolus of salbutamol (250 μg) and heliox via facemask. His worsening status necessitated invasive ventilation. His hypercapnia and resultant respiratory acidosis improved rapidly, but there was a concurrent accumulation of lactic acid resulting in acidemia. This patient had lactic acidosis as a direct effect of administration of salbutamol. The development of hazardous salbutamol-induced toxicity in acute severe asthma is discussed.

Item Type:	Article
Divisions :	Faculty of Health and Medical Sciences > School of Biosciences and Medicine
Authors :	Name Email ORCID Creagh-Brown, Ben C. b.creagh-brown@surrey.ac.uk Ball, J.
Date :	May 2008
DOI :	10.1016/j.ajem.2007.07.035
Depositing User :	Clive Harris
Date Deposited :	26 Mar 2019 11:51
Last Modified :	26 Mar 2019 11:51
URI:	http://epubs.surrey.ac.uk/id/eprint/850779

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