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May 24, 1971

Acute, Reversible Respiratory Acidosis in Cardiogenic Pulmonary Edema

Author Affiliations

From the Department of Medicine and the Pulmonary Function Laboratory, Mount Sinai Hospital Services-City Hospital Center at Elmhurst, Elmhurst, NY; and the Mount Sinai School of Medicine, The City University of New York.

JAMA. 1971;216(8):1315-1319. doi:10.1001/jama.1971.03180340035008

Acute, often severe, respiratory acidosis which cleared within several hours was noted in ten patients with classic cardiogenic pulmonary edema. Mental obtundation was present in five. Only three of the ten patients had received narcotics. Treatment was directed at the pulmonary edema and usually included intermittent positive pressure breathing. Coexisting metabolic acidosis was mild; two patients had associated metabolic alkalosis. On presentation, the mean Pco2 was 64.9 mm Hg and mean pH 7.20; after several hours of treatment, pH was normal and Pco2 minimally reduced. In view of these findings in pulmonary edema, emphasis should be placed on analysis of the arterial blood gases, a free airway, and supported ventilation.