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Take my breath away: a case of lactic acidosis in an asthma exacerbation

Published online by Cambridge University Press:  11 May 2015

Reid McGonigle  and
Robert A. Woods
Reid McGonigle*
Affiliation:
Île-à-la-Crosse Hospital, Île-à-la-Crosse, SK
Robert A. Woods
Affiliation:
Department of Surgery, College of Medicine, University of Saskatchewan, Saskatoon, SK
*
Île-à-la-Crosse Hospital, Île-à-la-Crosse, Sk SOM 1CO; reid.m@usask.ca

Abstract:

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A 36-year-old male with a history of chronic asthma presented to an emergency department with shortness of breath consistent with an asthma exacerbation. He had persistent tachypnea following inhaled bronchodilator treatment; thus, the workup and differential diagnosis were expanded. He was found to have a mixed respiratory alkalosis and metabolic acidosis with elevated serum lactate without an obvious cause and was admitted to hospital. His case was reviewed, and the lactic acidosis was thought to be caused by inhaled β2-agonist use. Emergency physicians should be aware of the potential side effects of inhaled β2-agonists as lactic acidosis may complicate clinical assessment and management of asthma exacerbations and lead to unnecessary and potentially dangerous escalations in therapy.

Keywords

asthmaβ2-agonistlactic acidosismetabolic acidosissalbutamol
Type
Case Report • Rapport de cas
Information
Canadian Journal of Emergency Medicine , Volume 13 , Issue 4 , July 2011 , pp. 284 - 288
Copyright
Copyright © Canadian Association of Emergency Physicians 2011

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