Acid-base abnormalities in adults with acute asthma are highly variable. The major abnormalities have been attributed to changes in PaCO2 secondary to altered alveolar ventilation. Primary metabolic alterations have been thought to be rare in adults.
The frequency of metabolic acidosis in acute asthma was reevaluated by way of a review of the medical records of 164 hospitalizations i…
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Metabolic acidosis as a presenting feature in acute asthma.
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Metabolic acidosis in status asthmaticus.
Blood gases and acid-base balance were measured in a group of patients in status asthmaticus. Simple or combined metabolic acidosis was found in 37.9% of the patients. In 25 of these, lactic acid (LA), pyruvic acid (PA) and LA/PA were increased.
Increased glycolysis and anaerobic respiratory muscle glycolysis during extreme airways obstruction may be instrumental in these changes. Ba… |
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Therapy of acute bronchospasm. Complicated by lactic acidosis and hypokalemia.
Hypokalemia and lactic acidosis developed following correction of respiratory acidosis in a 5-year-old child who presented with respiratory failure secondary to severe asthma and treated with theophylline, inhaled albuterol, and parenteral methylprednisolone. Calculation of the "anion gap" that provided the clue to presence of lactic acidosis was confirmed by the measurement of serum lac…
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Lactic acidosis in status asthmaticus : three cases and review of the literature…
Lactic acidosis is a frequent laboratory finding in patients with severe exacerbations of asthma. The pathogenesis of lactic acidosis in asthma is not well understood, but it has been presumed, by some, to be generated by fatiguing respiratory muscles.
We herein report the cases of three patients with status asthmaticus and lactic acidosis despite pharmacologic muscle relaxation. No … |
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Lactic acidosis in asthma: report of two cases and review of the literature.
Lactic acidosis is commonly associated with states of hypoxia and decreased tissue perfusion. Elevated lactic acid levels have also been observed in individuals who are not septic and who are normotensive, but who have received systemic adrenergic agonist therapy.
This report presents two patients with acute asthma treated with very large doses of aerosolized and systemic salbutamol,… |
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Lactic acidosis and status asthmaticus: how common in pediatrics?
BACKGROUND: Lactic acidosis is a well described phenomenon in adult patients with severe asthma. However, this entity is rarely reported in children with status asthmaticus.
OBJECTIVE: To report our experience in a 13-year-old girl who developed lactic acidosis as a complication of status asthmaticus and to investigate the prevalence of this complication of severe asthma. We sought t… |
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Elevated plasma lactate level associated with high dose inhaled albuterol therap…
BACKGROUND: Lactic acidosis is a recognised event in adult patients with status asthmaticus, particularly in the setting of intensive care. However, it has been infrequently studied in patients attending the emergency departments (ED).
METHODS: We conducted a prospective and descriptive study to assess levels of lactate and effects on bronchodilator response in adult patients with ac… |
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Metabolic acidosis not due to lactic acidosis in patients with severe acute asth…
Asthmatics seeking emergency care for severe acute asthma may show metabolic acidosis. We sought to determine the frequency of metabolic acidosis in such patients and to assess the relative contributions of renal bicarbonate loss and lactic acid accumulation to this acidosis.
Twenty-two asthmatics (21-71 yr; four males, and 18 females) who came consecutively to the emergency departme… |
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Lactic acidosis in severe asthma.
Twelve patients with severe asthma in whom lactic acidosis developed are presented. All had an arterial blood pH level lower than that expected for the measured partial pressure of arterial carbon dioxide, all had an abnormally large anion gap, and the blood lactate level exceeded 2.8 mmol/liter. Respiratory acidosis subsequently developed in eight patients, and six required intubation. |
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Hyperlactatemia during acute severe asthma.
OBJECTIVE: To evaluate arterial lactate levels during treatment of acute severe asthma (ASA) and the prognostic value of arterial hyperlactatemia in ASA.
DESIGN: Prospective study. SETTING: A respiratory intensive care unit (ICU) of a university hospital. PATIENTS: 29 consecutive patients admitted to the ICU for ASA not intubated on admission and with a pe… |
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Blood studies in untreated patients with acute asthma.
Arterial and venous blood samples were obtained from 23 patients with acute asthma before they received systemic or intermittent positive-pressure breathing therapy.
Serum lactate, electrolyte, and enzyme concentrations, arterial pH, arterial PCO2, arterial PO2, peak expiratory flows, and 2,3-diphosphoglycerate concentrations were measured. The serum glutamic oxaloaceti… |
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Acidosis in severe acute asthma.
On admission to intensive care units, the acid-base profile in acute severe asthma appears to be more diverse than previously. Especially a mixed or less frequently metabolic acidosis is eventually observed, which is not always caused by elevated lactate.
On the other hand, hyperlactatemia is actually rather common, not necessarily accompanied by acidosis. This finding is as a rule r… |
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Acid-base disturbances in acute asthma.
The clinical features, arterial blood gases, and acid-base profile were examined in 229 consecutive episodes of acute asthma in 170 patients who required hospitalization.
A simple respiratory alkalosis was the most common acid-base disturbance, occurring in 48 percent of the episodes. Metabolic acidosis, either alone or as part of a mixed disturbance, was noted in 28 percent. Of 60 e… |
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