Metabolic acidosis as an underlying mechanism of respiratory distress in children with severe acute asthma*

@article{Meert2007MetabolicAA,
  title={Metabolic acidosis as an underlying mechanism of respiratory distress in children with severe acute asthma*},
  author={Kathleen L. Meert and Jeff A. Clark and Ashok P. Sarnaik},
  journal={Pediatric Critical Care Medicine},
  year={2007},
  volume={8},
  pages={519-523}
}
Objective: 1) To alert the clinician that increasing rate and depth of breathing during treatment of acute asthma may be a manifestation of metabolic acidosis with hyperventilation rather than worsening airway obstruction; and 2) to describe the frequency of metabolic acidosis with hyperventilation in children with severe acute asthma admitted to our pediatric intensive care unit. Design: Retrospective medical record review. Setting: University-affiliated children's hospital. Patients: All… 
Metabolic acidosis, respiratory distress, and children with severe acute asthma.
  • P. Ramnarayan, R. Chhabra, P. Maheshwari
  • Medicine
    Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
  • 2009
TLDR
A retrospective audit of all acute asthma referrals in a 2-mo period suggested that the findings are related to high doses of 2 agonists and perhaps to the duration of exposure, and hypothesized that with longer infusion times, metabolic effects of intravenous salbutamol become more pronounced.
Mechanism of lactic acidosis in children with acute severe asthma
  • K. Meert, LaTasha McCaulley, A. Sarnaik
  • Medicine
    Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
  • 2012
TLDR
Investigating the incidence of hyperlactatemia and lactic acidosis in children with acute severe asthma and determining whether lactate elevation is type A or B found it to be primarily type B occurring in the presence of normal oxygen delivery to show consistency in type A and B patients.
Prevalence and risk factors of lactic acidosis in children with acute moderate and severe asthma, a prospective observational study
TLDR
Lactic acidosis is a frequent and early complication of acute moderate or severe asthma in children and is associated with b2-mimetics administration during acute asthma, according to a prospective observational study conducted in a tertiary hospital.
Hyperglycemia in Children Hospitalized with Acute Asthma.
TLDR
It is concluded that hyperglycemia is common in children hospitalized with acute asthma, and could be considered as a marker of a longer hospital stay.
Take my breath away: a case of lactic acidosis in an asthma exacerbation.
TLDR
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.
Fatal and near-fatal asthma in children: the critical care perspective.
Extreme Stress Hyperglycemia During Acute Illness in a Pediatric Emergency Department
TLDR
Although rare, ESH does occur in acute pediatric illness, in most cases is at least partially iatrogenic, and is a marker of severe illness and high mortality.
Quantitative analysis of acid-base disorders in patients with chronic respiratory failure in stable or unstable respiratory condition.
TLDR
In patients with chronic respiratory failure the acid-base pattern is complex, metabolic alkalosis is present in some patients with elevated HCO₃⁻, and metabolic acidosis ispresent in some with non-elevated HCO ₃¬⁽, even when corrected anion gap was taken into account.
Getting Burned by Lactic Acid.
TLDR
A 13-year-old boy with a history of moderate, persistent asthma was transferred to the authors' facility from an outside hospital with shortness of breath and cough of 2 days’ duration with persistently elevated lactate levels, which triggered additional fluid boluses and order for blood culture.
Insulin therapy in hyperglycemic children with severe acute asthma
TLDR
The question is whether this protocol is efficacious for the treatment of pediatric SAA associated with hyperglycemia, and considering that the insulin protocol is labor-intensive, the answer is likely to be yes.
...
...

References

SHOWING 1-10 OF 36 REFERENCES
Lactic acidosis and status asthmaticus: how common in pediatrics?
  • E. Yousef, S. Mcgeady
  • Medicine
    Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology
  • 2002
Metabolic acidosis not due to lactic acidosis in patients with severe acute asthma.
TLDR
Nonanion gap metabolic acidosis is very common in asthmatics with acute severe asthma and the mechanism of the base deficit in these patients is excessive renal bicarbonate excretion, which occurs as a renal compensatory response to a preceding period of hypocapnia due to hyperventilation related to worsening asthma.
Acid-base disturbances in acute asthma.
TLDR
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 and it is concluded that metabolic acidosis is a common finding in acute, severe asthma.
Metabolic acidosis as a presenting feature in acute asthma.
TLDR
It is concluded that the presenting acid-base status of adults with acute asthma is highly variable and metabolic acidosis is not an infrequent finding.
Metabolic acidosis as a presenting feature in acute asthma.
TLDR
It is concluded that the presenting acid-base status of adults with acute asthma is highly variable and metabolic acidosis is not an infrequent finding.
Hyperlactatemia during acute severe asthma
TLDR
This study suggests that, in ASA, arterial hyperlactatemia is frequently present on admission to the ICU and a constant finding during treatment of ASA, and the effects of therapy for acute asthma on lactate metabolism still need to be studied.
Lactic acidosis associated with the usual theophylline dose in a patient with asthma
  • Y. Koh, I. Choi
  • Medicine
    The Korean journal of internal medicine
  • 2002
TLDR
It is suggested that a possibility of theophylline-associated metabolic abnormalities should be considered when an asthmatic patient given the usual theophyLLine dose presents with lactic acidosis, hypokalemia and hyperglycemia of unknown etiology.
Epinephrine-induced lactic acidosis in the setting of status asthmaticus.
TLDR
A 20-year-old woman with a history of asthma came to the emergency service in acute respiratory distress and was treated with subcutaneous epinephrine, and six hours later, serial arterial blood gas studies revealed the onset of a primary metabolic acidosis.
Lactic acidosis in asthma: report of two cases and review of the literature.
TLDR
Two patients with acute asthma treated with very large doses of aerosolized and systemic salbutamol, who developed lactic acidosis despite normal systemic hemodynamics and adequate oxygenation, were presented.
Lactic acidosis in status asthmaticus : three cases and review of the literature.
TLDR
No common etiologies were found for lactic acidosis that abated after bronchospasm improved and the intensity of pharmacologic therapies was reduced, and mechanisms by which lactic acids occur in patients with status asthmaticus were discussed.
...
...