Ventilation/Perfusion Mismatch in a Child Following Cocaine Ingestion: Case Report

Jacqueline Jones, Palen Mallory
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Abstract

The effects of acute cocaine toxicity on lung physiology and potential ventilation/perfusion (V/Q) mismatch in children is not well described. Herein, we report a case of V/Q mismatch and profound end-tidal CO2 (EtCO2) to serum partial pressure CO2 (PCO2) discordance occurring in a child who tested positive for cocaine, thought to be from cocaine-induced pulmonary vasospasm (dead space). This has not previously been described in the pediatric population. Clinicians should consider the possibility of cocaine-induced pulmonary vasospasm and V/Q mismatch in children with altered mental status and otherwise unexplained significant EtCO2 and PCO2 discordance.

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一名儿童摄入可卡因后出现通气/灌注不匹配:病例报告
急性可卡因中毒对儿童肺部生理学和潜在通气/灌注(V/Q)失配的影响尚未得到很好的描述。在此,我们报告了一例可卡因检测呈阳性的儿童出现 V/Q 失配和潮气末二氧化碳(EtCO2)与血清二氧化碳分压(PCO2)严重不一致的病例,这可能是可卡因引起的肺血管痉挛(死腔)所致。这种情况以前从未在儿科人群中出现过。对于精神状态改变和其他原因无法解释的明显 EtCO2 和 PCO2 不一致的儿童,临床医生应考虑可卡因诱发肺血管痉挛和 V/Q 不匹配的可能性。
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