A 58-Year-Old Man With Episodic Hypercapnic Respiratory Failure
| Autor: | Zaeem A. Siddiqi, Jennifer A. McCombe, Jocelyn M. Slemko, Nasser Y. AlOhaly, Candace M. Marsters, Adam Romanovsky, Nathan Y. Chu |
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| Rok vydání: | 2021 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine Bicalutamide Hypophonia Critical Care and Intensive Care Medicine Vertigo medicine Carcinoma Humans Medical history biology business.industry Middle Aged medicine.disease biology.organism_classification Dysphagia Docetaxel Anesthesia medicine.symptom Presentation (obstetrics) Respiratory Insufficiency CHEST Pearls Cardiology and Cardiovascular Medicine business Paraneoplastic Syndromes Nervous System medicine.drug |
| Zdroj: | Chest |
| ISSN: | 0012-3692 |
| DOI: | 10.1016/j.chest.2021.03.065 |
| Popis: | Case Presentation A 58-year-old man presented to the ED with a 1-week history of progressive weight loss, generalized weakness, unsteadiness, and dizziness. In hospital, he experienced a witnessed episode of loss of consciousness with no observable respirations that lasted for 15 minutes. His arterial blood gas demonstrated hypercapnic respiratory failure, and he required mask ventilation and vasoactive medications. Similar episodes occurred several more times over the course of the night that required the patient to be intubated. The paroxysmal episodes persisted necessitating continued invasive ventilatory support and admission to the ICU. The episodes occurred in both awake and asleep states and required the ventilator settings to dictate a minimum rate, but minimal ventilatory support otherwise. Further history revealed other symptomatic complaints of vertigo, dysphagia, and hypophonia that had progressed over a 2-month period. The patient’s medical history was pertinent for a diagnosis of prostatic carcinoma 3 years previously that was found to be castrate resistant. He had metastases to his hip, ribs, and thoracic spine. Previous treatments had included bicalutamide, docetaxel, and abiraterone; he was receiving leuprolide therapy on presentation. |
| Databáze: | OpenAIRE |
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