A Respiratory Failure Patient with CO2 Narcosis Successfully Treated with Kampo Medicines / 日本東洋医学雑誌

ABSTRACT

We experienced a refractory case of respiratory failure with CO2 narcosis after respiratory tract infection successfully treated with daikenchuto, ninjinyoeito, and bushimatsu. The patient was an 88-year-old woman with pulmonary tuberculosis sequelae and chronic obstructive pulmonary disease for which she had been receiving tiotropium, a budesonide inhalation suspension, and tulobuterol patches. She developed a fever and persistent dyspnea and was taken to our hospital by ambulance. Initially, artificial respiration was recommended because she had CO2 narcosis, but this intervention was rejected because of her advanced age. She showed persistent dyspnea and mild consciousness disturbance. Therefore, treatments by daikenchuto, ninjinyoeito, and bushimatsu were gradually introduced. As a result, her dyspnea, constipation, anorexia, and decreased consciousness improved, and the CO2 concentrations in arterial blood decreased with normalization of pH level. Artificial respiration management is the first-choice treatment for aggravated chronic respiratory failure with CO2 narcosis. However, when such medical management is not feasible, as in the present case, Kampo medicines may contribute to alleviating symptoms of respiratory failure.