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Original email says continuous Albuterol drip...type o or do I have to start reading more...A kid with status asthmaticus huffing and puffing, hypermetabolic from the disease process and the meds, I would not be surprised if elevated. Maybe use like a crp in these particular asthmatic kids, meaning if elevated in conjunction with other specific parameters...Not sure it registers on my Careometer, at this point. Did get me thinking...Todd ZGo GreenGo KnicksAnd for laughs, my wife made me get a teacup maltese named Chanel...I am now one of them! Don't hate.


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-------- Original message --------From: Gill Winnik <[log in to unmask]> Date: 7/6/16  9:34 PM  (GMT-05:00) To: [log in to unmask] Subject: Re: Lactic Acidosis and status asthmaticus 
Most VBG/ABG samples come back with the lactate as well, so we get to see it whether we ordered it or not....
Giora 

Sent from my iPad

> On Jul 6, 2016, at 8:00 PM, Rebecca Reamy <[log in to unmask]> wrote:
> 
> I agree. Why would you check?
> 
>> On Wed, Jul 6, 2016 at 4:56 PM, Simon P. Ros <[log in to unmask]> wrote:
>> 
>> My question is - how would I know that my asthmatic patient has lactic
>> acidosis ? I usually do not send any lab tests on my asthmatic patients.
>> 
>> Sent from my iPhone
>> 
>>> On Jul 6, 2016, at 3:51 PM, Tim Horeczko <[log in to unmask]> wrote:
>>> 
>>> Great discussion item!
>>> 
>>> Albuterol itself can cause a rise in lactate level:
>>> 
>>> https://urldefense.proofpoint.com/v2/url?u=http-3A__www.ncbi.nlm.nih.gov_pubmed_26857949&d=CwIBaQ&c=djx4x_Lu5jS1_mKMB7WBGhXdIwpne1KOnJAaisGB74Q&r=exvi3q-J52PR7GzZVteuwfhRX2j70zxRa9Sp7tvqwdc&m=23S1mr2CN1xAeok00NonfLFLpWwLHh43jfisU3yfo2U&s=LKYAp1gVK_EoNAyoEmJAT85fMF3ai2jq2srdH0OCMz4&e= 
>>> 
>>> https://urldefense.proofpoint.com/v2/url?u=http-3A__www.ncbi.nlm.nih.gov_pubmed_26744665&d=CwIBaQ&c=djx4x_Lu5jS1_mKMB7WBGhXdIwpne1KOnJAaisGB74Q&r=exvi3q-J52PR7GzZVteuwfhRX2j70zxRa9Sp7tvqwdc&m=23S1mr2CN1xAeok00NonfLFLpWwLHh43jfisU3yfo2U&s=MhtiWsqGFt7hk_cc66qDGagt_cacQ39WXI-h96QWfRc&e= 
>>> 
>>> https://urldefense.proofpoint.com/v2/url?u=http-3A__www.ncbi.nlm.nih.gov_pubmed_24394811&d=CwIBaQ&c=djx4x_Lu5jS1_mKMB7WBGhXdIwpne1KOnJAaisGB74Q&r=exvi3q-J52PR7GzZVteuwfhRX2j70zxRa9Sp7tvqwdc&m=23S1mr2CN1xAeok00NonfLFLpWwLHh43jfisU3yfo2U&s=2AnHUZZXMHJzVSL5WlN2qDaIWvqKcLC2z3bYU5fFgGU&e= 
>>> 
>>> The picture can be muddied if there is concomitant infection; also
>>> albuterol overdose can cause diastolic hypotension...
>>> 
>>> I think this is a good reminder for us that not all hyperlactatemia is
>>> sepsis.
>>> 
>>> Interested in others' experience -- thanks!
>>> 
>>> 2016-07-06 12:52 GMT-07:00 Gill Winnik <[log in to unmask]>:
>>> 
>>>> A recent discussion in our group was the management of child in status
>>>> asthmaticus and continuous albuterol drip who develops lactic acidosis (
>>>> but is does not have any other obvious signs of sepsis).
>>>> Can members of the list comment on their experience?
>>>> 
>>>> Giora Winnik MD
>>>> Maimonides/Brooklyn
>>>> 
>>>> For more information, send mail to [log in to unmask] with the
>>>> message: info PED-EM-L
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>>> 
>>> For more information, send mail to [log in to unmask] with the
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> 
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