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Pulmonary and Critical Care Pearls |

A Case of Hypercapnic Respiratory Failure*

Daniel Baram, MD; FCCP; Aklilu Degene, MD; Mohammad Amin, MD; Thomas Bilfinger, MD, ScD, FCCP; Gerald Smaldone, MD, PhD, FCCP
Author and Funding Information

*From the Division of Pulmonary and Critical Care Medicine (Drs. Baram, Degene, Amin, and Smaldone), and the Division of Cardiothoracic Surgery (Dr. Bilfinger), State University of New York–Stony Brook, Stony Brook, NY.

Correspondence to: Daniel Baram, MD, FCCP, Assistant Professor of Medicine Division of Pulmonary and Critical Care Medicine, SUNY-Stony Brook, T-17 040 HSC, Stony Brook, NY 11794-8172; e-mail: daniel.baram@stonybrook.edu



Chest. 2004;126(6):1994-1999. doi:10.1378/chest.126.6.1994
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A 60-year-old man presented to an outside facility with hypercapnic respiratory failure requiring intubation and mechanical ventilation. He underwent diuresis for a presumptive diagnosis of congestive heart failure, was extubated, and was transferred to our university hospital for cardiac catheterization.

His dyspnea had been progressive over many years and was refractory to adjustments in his cardiac medications. A recent nuclear stress test showed reversible ischemia. He had a 20-year history of hypertension and diabetes mellitus with progressive nephropathy and retinopathy. He had a 100 pack-year smoking history and a remote asbestos exposure as a member of the Merchant Marine. Outpatient medications were rosiglitazone, 4 mg qd, quinapril, 10 mg qd, carvedilol, 6.25 mg bid, torsemide, 100 mg qd, metolazone, 5 mg qd, and timolol ophthalmic drops.

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