Acute ventilatory failure from sniffing paint.
نویسنده
چکیده
COMMUNICATIONS TO THE EDITOR 681 resenting supraventricular tachycardia with aberrant ventricular conduction. Rapid administration of digitalis was started, and one hour later the rate dropped abruptly to 50 beats per minute. Intravenous therapy with isoproterenol, dopamine, and sodium bicarbonate was administered, and the rate varied between 70 and 160 beats per minute. Eight hours after admission, a consultant in cardiology reviewed the patient’s electrocardiograms and course and believed that the findings were best explained by adrenal insufficiency with hyperkalemia, despite normal levels of sodium and potassium at admission, tachyarrhythmia rather than bradyarrhythmia, and clear absence of significant dehydration. Determinations of serum electrolyte levels were reordered and revealed a sodium level of 123 mEq/L and a potassium level of 9.6 mEq/L. Corticosteroids were administered intravenously. A variety of disturbances in rhythm occurred, including atrial flutter with rapid and slow ventricular responses. A transvenous atrial pacemaker was inserted, which produced ventricular capture at a rate of 160 beats per minute. An hour later, asystole that was unresponsive to the pacemaker occurred, and the infant was pronounced dead. On the following morning the sample of serum obtained at admission, from which the normal values for sodium and potassium levels had previously been obtained, was located, and the determinations were repeated. On this occasion the serum sodium level was found to be 122 mEq/L, and the serum potassium level was 10.1 mEq/L. At necropsy the adrenal glands of this patient were found to be approximately the same size as the kidneys (a combined adrenal weight of 18.6 gm).
منابع مشابه
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ورودعنوان ژورنال:
- Chest
دوره 71 5 شماره
صفحات -
تاریخ انتشار 1977