Chest
Prolonged Neurogenic Weakness in Patients Requiring Mechanical Ventilation for Acute Airflow Limitation
Section snippets
CASE 1
A 41-year-old male nonsmoker with long-standing asthma had become increasingly breathless despite increasing his oral prednisolone dosage from 10 mg to 40 mg daily. At the time of hospital admission, he was dyspneic, wheezy, and sweating, with a pulse rate of 140 beats/min. Nebulized salbutamol, intravenous aminophylline, and hydrocortisone failed to prevent deterioration and mechanical ventilation was instituted. He received intravenous infusions of salbutamol, aminophylline, hydrocortisone,
DISCUSSION
There have been several reports of weakness in patients requiring mechanical ventilation for acute severe asthma.1, 2, 3, 4, 5 These patients typically presented with weaning difficulties and flaccid weakness affecting both proximal and distal muscle groups with preserved tendon reflexes and without sensory involvement. All had received intravenous sedatives and muscle relaxants together with specific medication for airway obstruction, including bronchodilators and steroids. Initial reports
ACKNOWLEDGMENT
We would like to thank Dr. R. W. H. Walker and Dr. J. D. Watson for their helpful advice and criticism.
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