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February 19, 1982

Myxedema Coma and Cardiac Arrest-Reply

JAMA. 1982;247(7):980. doi:10.1001/jama.1982.03320320020021

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In Reply.—  We appreciate the comments of Drs Georgitis and Hofeldt. In response to their question, the time relationships were as follows: At 7 PM, the pH was 7.33; Pco2, 48 mm Hg; Po2, 51 mm Hg. At 7:10 PM oxygen therapy was begun. At 8 PM, pH was 7.31; Pco2, 46 mm Hg; Po2, 72 mm Hg. At 11:45 PM the patient was alert and responsive. At 2 AM the patient was lethargic, and levothyroxine was administered intravenously (IV). At 2:10 AM, after cardiopulmonary resuscitation, pH was 7.34; Pco2, 42 mm Hg; Po2, 58 mm Hg.The Pco2, was measured at 37 °C and not corrected for the patient's temperature. With the appropriate correction for hypothermia, the Pco2 at 8 PM after one hour on oxygen becomes 41.3 mm Hg.Thus, it does not appear that in this instance oxygen therapy