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Pulmonary and Critical Care Pearls |

A 47-Year-Old Woman With Wheezing and Respiratory Failure Unresponsive to Conventional Ventilatory Modalities*

David L. Dedrick, MD; Lee K. Brown, MD, FCCP; Douglas W. Mapel, MD, MPH, FCCP
Author and Funding Information

*From the Division of Pulmonary, Allergy, and Critical Care (Drs. Dedrick and Mapel), University of New Mexico School of Medicine; and the Division of Pulmonary and Critical Care Medicine (Dr. Brown), Lovelace Physician Group, Albuquerque, NM.

Correspondence to: Lee K. Brown, MD, FCCP, Lovelace Health Systems, 4700 Jefferson Blvd NE, Suite 800, Albuquerque, NM 87109; e-mail: lkbrown@alum.mit.edu



Chest. 2002;121(5):1688-1691. doi:10.1378/chest.121.5.1688
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Extract

A 47-year-old woman presented to the emergency department complaining of 2 days of increasing shortness of breath despite escalating use of albuterol by metered-dose inhaler (MDI). She had a long history of bronchial asthma, including one hospital admission for status asthmaticus with respiratory failure requiring intubation and ventilatory support. That hospitalization had been complicated by a slowly resolving myopathy from paralytic agents and corticosteroids prompting tracheotomy and a prolonged period of ventilatory support. She denied fever, facial pain, nasal discharge, or other symptoms of sinusitis, and her cough was nonproductive. Medications included albuterol MDI, fluticasone MDI, and diltiazem for mild hypertension.

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