Impaired hypoxic ventilatory drive induced by diabetic autonomic neuropathy, a cause of misdiagnosed severe cardiac events: brief report of two cases

Abstract Background Sudden cardiac deaths are twice more frequent in diabetic patients with autonomic neuropathy. death etiologies remain unclear and no recommendations made to identify factors associated cardiorespiratory arrest patients. We hypothesized, from two clinical cases, that impaired hypoxic ventilatory drive, induced by neuropathy, is a cause of misdiagnosed severe events. Case presentation describe the cases isolated low blood saturation on pulse oximeter during systematic nurse check-up (77% 85% respectively) contrasting absence any complaint such as dyspnea, polypnea or other respiratory insufficiency signs observed examination. Arterial gas measurements subsequently confirmed oxygen was both were indeed hypoxemic. Patient 1 suffered vascular overload complicated caused hypoxemia light quick recovery after ventilation. Pulmonary edema diagnosed patient 2. The common denominator these 2 described this brief report failure presence hypoxemia. Also, precursory seems be an drive This appears related neuropathy encountered those Conclusions Therefore, we describe, report, involved acute events type assume altered response due non-functional central neurological breathing command could play key role sudden among An important point can easily missed since reported cases. Systematic screening proactive detection for early management (e.g. treatment hypoxemia) should systematically undertaken prevent its dramatic consequences death.