A case-based discussion from the Medical Intensive Care Unit of Sahloul University Hospital of Tunisia: an unusual cause of alveolar hypoventilation in a patient with COPD
Arterial blood gas (ABG) analysis on room air disclosed severe respiratory acidosis with hypercapnia and high bicarbonate level (pH=7.14, pCO2=11 kPa, [Formula omitted. Subsequently, because of a rapid deterioration of the level of consciousness, as assessed by a fall in Glasgow coma score (GCS) to...
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| Veröffentlicht in: | Thorax 2015-10, Vol.70 (10), p.1004-1006 |
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| creator | Mejri, Olfa Beji, Olfa Ben Salem, Chaker Hmouda, Houssem |
| description | Arterial blood gas (ABG) analysis on room air disclosed severe respiratory acidosis with hypercapnia and high bicarbonate level (pH=7.14, pCO2=11 kPa, [Formula omitted. Subsequently, because of a rapid deterioration of the level of consciousness, as assessed by a fall in Glasgow coma score (GCS) to 6/15, the patient required intubation, sedation and mechanical ventilation. [...]Retama raetam is known for its quinolizidine alkaloid properties and for its pharmacological and toxicological activity with diuretic, hypoglycaemic, hypotensive, hallucinogenic and respiratory depressant effects. 5 6 The clinical presentation of our patient, the absence of the usual causes of COPD exacerbation, the presence of quinolizidine alkaloid metabolites in the urine and the spontaneous favourable outcome with symptomatic treatment alone (mechanical ventilation, vasoactive agents and fluid resuscitation), without any specific therapy, are strong arguments supporting our hypothesis. |
| doi_str_mv | 10.1136/thoraxjnl-2015-207034 |
| format | Article |
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Subsequently, because of a rapid deterioration of the level of consciousness, as assessed by a fall in Glasgow coma score (GCS) to 6/15, the patient required intubation, sedation and mechanical ventilation. [...]Retama raetam is known for its quinolizidine alkaloid properties and for its pharmacological and toxicological activity with diuretic, hypoglycaemic, hypotensive, hallucinogenic and respiratory depressant effects. 5 6 The clinical presentation of our patient, the absence of the usual causes of COPD exacerbation, the presence of quinolizidine alkaloid metabolites in the urine and the spontaneous favourable outcome with symptomatic treatment alone (mechanical ventilation, vasoactive agents and fluid resuscitation), without any specific therapy, are strong arguments supporting our hypothesis.</description><identifier>ISSN: 0040-6376</identifier><identifier>EISSN: 1468-3296</identifier><identifier>DOI: 10.1136/thoraxjnl-2015-207034</identifier><identifier>PMID: 26123661</identifier><identifier>CODEN: THORA7</identifier><language>eng</language><publisher>England: BMJ Publishing Group LTD</publisher><subject>Abdomen ; Coma ; Genista - adverse effects ; Hospitals, University ; Humans ; Hypoventilation - diagnosis ; Hypoventilation - etiology ; Hypoventilation - therapy ; Intensive care ; Intensive Care Units ; Laboratories ; Male ; Medical imaging ; Metabolic disorders ; Metabolites ; Middle Aged ; Mortality ; Nervous system ; Pulmonary Disease, Chronic Obstructive - complications ; Respiratory distress syndrome ; Teas, Herbal - adverse effects ; Tunisia ; Urine ; Ventilation ; Weaning</subject><ispartof>Thorax, 2015-10, Vol.70 (10), p.1004-1006</ispartof><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</rights><rights>Copyright: 2015 Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-b280t-dbfe329b294c967108e49f7d3b747df3cedb695515e0ed9e8bba3b4a6e5481ff3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://thorax.bmj.com/content/70/10/1004.full.pdf$$EPDF$$P50$$Gbmj$$H</linktopdf><linktohtml>$$Uhttps://thorax.bmj.com/content/70/10/1004.full$$EHTML$$P50$$Gbmj$$H</linktohtml><link.rule.ids>114,115,314,776,780,23550,27901,27902,77569,77600</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26123661$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mejri, Olfa</creatorcontrib><creatorcontrib>Beji, Olfa</creatorcontrib><creatorcontrib>Ben Salem, Chaker</creatorcontrib><creatorcontrib>Hmouda, Houssem</creatorcontrib><title>A case-based discussion from the Medical Intensive Care Unit of Sahloul University Hospital of Tunisia: an unusual cause of alveolar hypoventilation in a patient with COPD</title><title>Thorax</title><addtitle>Thorax</addtitle><description>Arterial blood gas (ABG) analysis on room air disclosed severe respiratory acidosis with hypercapnia and high bicarbonate level (pH=7.14, pCO2=11 kPa, [Formula omitted. Subsequently, because of a rapid deterioration of the level of consciousness, as assessed by a fall in Glasgow coma score (GCS) to 6/15, the patient required intubation, sedation and mechanical ventilation. [...]Retama raetam is known for its quinolizidine alkaloid properties and for its pharmacological and toxicological activity with diuretic, hypoglycaemic, hypotensive, hallucinogenic and respiratory depressant effects. 5 6 The clinical presentation of our patient, the absence of the usual causes of COPD exacerbation, the presence of quinolizidine alkaloid metabolites in the urine and the spontaneous favourable outcome with symptomatic treatment alone (mechanical ventilation, vasoactive agents and fluid resuscitation), without any specific therapy, are strong arguments supporting our hypothesis.</description><subject>Abdomen</subject><subject>Coma</subject><subject>Genista - adverse effects</subject><subject>Hospitals, University</subject><subject>Humans</subject><subject>Hypoventilation - diagnosis</subject><subject>Hypoventilation - etiology</subject><subject>Hypoventilation - therapy</subject><subject>Intensive care</subject><subject>Intensive Care Units</subject><subject>Laboratories</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Metabolic disorders</subject><subject>Metabolites</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Nervous system</subject><subject>Pulmonary Disease, Chronic Obstructive - complications</subject><subject>Respiratory distress syndrome</subject><subject>Teas, Herbal - adverse effects</subject><subject>Tunisia</subject><subject>Urine</subject><subject>Ventilation</subject><subject>Weaning</subject><issn>0040-6376</issn><issn>1468-3296</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNpdkcFu1DAQhi0EotvCI4AsceklYMeJnXCrFkorFbVS23NkxxPFK8cOsb10n4mXxNGWHriM7fk_z4zmR-gDJZ8pZfxLHP0in3bOFiWhdQ6CsOoV2tCKNwUrW_4abQipSMGZ4CfoNIQdIaShVLxFJyWnJeOcbtCfC9zLAIXKQWNtQp9CMN7hYfETjiPgn6BNLy2-dhFcMHvAW7kAfnQmYj_gezlan-z63sMSTDzgKx9mE_OXLD8kZ4KRX7F0OLkUUk73MgVYRWn34K1c8HiY_R5cNFbGtblxWOI533MO_zZxxNvbu2_v0JtB2gDvn88z9Hj5_WF7Vdzc_rjeXtwUqmxILLQaIC9AlW3Vt1xQ0kDVDkIzJSqhB9aDVryta1oDAd1Co5RkqpIc6qqhw8DO0Pmx7rz4XwlC7Ka8F7BWOvApdFTQUohcmmX003_ozqfF5eky1dCmrLmoM_XxmUpqAt3Ni5nkcuj-2ZABcgTUtHtRKelWp7sXp7vV6e7oNPsL_BqeiQ</recordid><startdate>201510</startdate><enddate>201510</enddate><creator>Mejri, Olfa</creator><creator>Beji, Olfa</creator><creator>Ben Salem, Chaker</creator><creator>Hmouda, Houssem</creator><general>BMJ Publishing Group LTD</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PHGZM</scope><scope>PHGZT</scope><scope>PJZUB</scope><scope>PKEHL</scope><scope>PPXIY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>201510</creationdate><title>A case-based discussion from the Medical Intensive Care Unit of Sahloul University Hospital of Tunisia: an unusual cause of alveolar hypoventilation in a patient with COPD</title><author>Mejri, Olfa ; 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Subsequently, because of a rapid deterioration of the level of consciousness, as assessed by a fall in Glasgow coma score (GCS) to 6/15, the patient required intubation, sedation and mechanical ventilation. [...]Retama raetam is known for its quinolizidine alkaloid properties and for its pharmacological and toxicological activity with diuretic, hypoglycaemic, hypotensive, hallucinogenic and respiratory depressant effects. 5 6 The clinical presentation of our patient, the absence of the usual causes of COPD exacerbation, the presence of quinolizidine alkaloid metabolites in the urine and the spontaneous favourable outcome with symptomatic treatment alone (mechanical ventilation, vasoactive agents and fluid resuscitation), without any specific therapy, are strong arguments supporting our hypothesis.</abstract><cop>England</cop><pub>BMJ Publishing Group LTD</pub><pmid>26123661</pmid><doi>10.1136/thoraxjnl-2015-207034</doi><tpages>3</tpages></addata></record> |
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| subjects | Abdomen Coma Genista - adverse effects Hospitals, University Humans Hypoventilation - diagnosis Hypoventilation - etiology Hypoventilation - therapy Intensive care Intensive Care Units Laboratories Male Medical imaging Metabolic disorders Metabolites Middle Aged Mortality Nervous system Pulmonary Disease, Chronic Obstructive - complications Respiratory distress syndrome Teas, Herbal - adverse effects Tunisia Urine Ventilation Weaning |
| title | A case-based discussion from the Medical Intensive Care Unit of Sahloul University Hospital of Tunisia: an unusual cause of alveolar hypoventilation in a patient with COPD |
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