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(Chest. 2001;119:1599-1602.)
© 2001 American College of Chest Physicians

Lactic Acidosis in Status Asthmaticus*

Three Cases and Review of the Literature

Constantine A. Manthous, MD, FCCP

* From the Pulmonary and Critical Care Division, Bridgeport Hospital and Yale University School of Medicine, Bridgeport, CT.

Correspondence to: Constantine A. Manthous, MD, FCCP, Bridgeport Hospital, 267 Grant St, PO Box 5000, Bridgeport, CT 06610

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 common etiologies were found for lactic acidosis that abated after bronchospasm improved and the intensity of pharmacologic therapies was reduced. We review the literature describing lactic acidosis with asthma and discuss mechanisms by which lactic acidosis may occur in patients with status asthmaticus.

Key Words: albuterol • asthma • bronchodilators • lactate • lactic acid • lactic acidosis • status asthmaticus • sympathomimetic




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