Beta-agonist toxicity cause metabolic acidosis with high lactate.

Learning point:

1. Careful in drawing conclusion more metabolic acidosis patient more severe.

2. Can present with high dose of salbutamol exposure, clear lungs, hyperventilation (compensating the metabolic acidosis), ABG with low PCO2, high DXT.

3. In such patient, tapering down of B-agonist will resolve the symptoms.

Ref:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3862915/

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