Title |
Central neurogenic hyperventilation treated with intravenous fentanyl followed by transdermal application
|
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Published in |
Journal of Anesthesia, August 2007
|
DOI | 10.1007/s00540-007-0526-x |
Pubmed ID | |
Authors |
Yushi U. Adachi, Hideki Sano, Matsuyuki Doi, Shigehito Sato |
Abstract |
Central neurogenic hyperventilation (CNH) is a rare clinical condition that is sometimes difficult to treat. We report a 51-year-old female patient who was successfully treated with intravenous fentanyl followed by transdermal fentanyl. She had a transient epileptic episode with a temporary loss of consciousness. Immediately before her admission to the intensive care unit (ICU), her Pa(CO2) and pH were 6.7 mmHg and 7.64, respectively. Rebreathing from a paper bag and the intravenous administration of diazepam failed to improve the decreased Pa(CO2). Therefore, we administered intravenous fentanyl, at the rate of 50 microg x h(-1). Two days after her admission to the ICU, the Pa(CO2) had increased gradually to 22.9 mmHg, and the pH to 7.50. Although infiltration of recurrent lymphoma to the brain became apparent, she remained active, without epilepsy or loss of consciousness, in a general ward for 1 month with transdermal fentanyl, treatment until she again became drowsy; she died on hospital day 58. Transdermal fentanyl seems to be a good palliative measure to treat CNH in patients who have advanced neoplasms. |
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Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 19 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
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Researcher | 6 | 32% |
Student > Bachelor | 4 | 21% |
Student > Ph. D. Student | 3 | 16% |
Student > Postgraduate | 2 | 11% |
Professor > Associate Professor | 1 | 5% |
Other | 1 | 5% |
Unknown | 2 | 11% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 14 | 74% |
Nursing and Health Professions | 1 | 5% |
Chemistry | 1 | 5% |
Agricultural and Biological Sciences | 1 | 5% |
Unknown | 2 | 11% |