Bilateral vocal cord paralysis for 26 years with respiratory failure. Timing of restoration of tidal volume and serum electrolytes after tracheostomy.

ABSTRACT

A 31-year-old man had respiratory failure caused by bilateral vocal cord paralysis. He had had limited exercise tolerance since the age of five years, when he had had poliomyelitis. Respiratory failure was present for at least three months. Following relief of the upper airway obstruction by tracheostomy, the patient's tidal volume increased from 200 ml to 500 ml in two days, his carbon dioxide tension fell from 75 to 38 mm Hg, and his arterial bicarbonate level decreased from 39.8 to 25.6 mEq/L in five days. The patient is currently doing well with a permanent tracheostomy.