Lactic Acidosis Associated with the Therapy of Acute Bronchospasm

To the Editor: Appel et al. recently concluded that lactic acidosis in severe asthma is secondary to the production of lactate by over-worked respiratory muscles. 1 However, recent studies suggest that beta-adrenergic drugs can induce lactic acidosis. 2 3 4 We report on a patient who presented with respiratory failure secondary to myasthenia gravis, in whom lactic acidosis developed in association with therapy for acute bronchospasm. A 22-year-old woman was admitted to the intensive care unit for respiratory failure due to cholinergic crisis associated with the therapy of myasthenia gravis. Physical examination revealed a heart rate of 104 bpm, a temperature of 38°C, . . .