Prolonged severe hypercapnia complicating near fatal asthma in a 35-year-old woman

Abstract

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.