A patient with severe asthma may develop a lactic acidosis associated with high doses of inhaled beta-agonists.
Initial clinical findings:
(1) The patient is having an exacerbation of asthma.
(2) The patient is treated aggressively, with therapy including inhaled beta-agonists.
(3) The patient is noted to be tachypneic.
Laboratory testing shows:
(1) There is a metabolic acidosis associated with elevated lactic acid.
(2) The PaCO2 is usually not elevated.
The patient quickly improves on discontinuation of beta-agonist therapy.
No other explanation for lactic acidosis is identified.
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