[Nebulized salbutamol as a possible cause of lactate acidosis in a patient with acute asthma].

A 50-year-old man was in the emergency department treated for acute asthma with repeated doses of nebulized salbutamol according to guidelines, and as a result of this treatment he developed marked lactate acidosis. Lactate acidosis is not commonly listed as a side effect to nebulized salbutamol. House officers in the emergency department handling acute asthma should be aware of this paradox, though the condition may resolve in spite of continued treatment with salbutamol.

Cerebral output of cytokines in patients with pneumococcal meningitis.

Objective: Patients with acute bacterial meningitis frequently develop sepsis, the hallmark of which is increased plasma cytokine levels. However, it is unknown whether the brain contributes to the intravascular accumulation of cytokines in meningitis. We measured the cerebral output of cytokines to the blood during severe pneumococcal meningitis accompanied by sepsis.

Cerebral blood flow and metabolism during infusion of norepinephrine and propofol in patients with bacterial meningitis.

Background And Purpose: In patients with severe bacterial meningitis, norepinephrine is often infused to increase mean arterial pressure (MAP). This increases cerebral blood flow (CBF), but it is unknown if this increase is caused by impaired cerebral autoregulation or by a cerebral effect of norepinephrine through increased cerebral metabolism. The latter possibility implies a CBF-metabolism coupling.