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An increase of glycolysis pathway leading to pyruvate escalation is the mechanism of hyperlactatemia in \u03b22-adrenergic agonist drug.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case presentation<\/jats:title><jats:p>A 40-year-old man who had poor-controlled asthma, presented with progressive dyspnea with coryza symptom for 6\u00a0days. He was intubated and admitted into medical intensive care unit due to deteriorated respiratory symptom. Severe asthmatic attack was diagnosed and approximate 1.5 canisters of salbutamol inhaler was administrated within 24\u00a0h of admission. Initial severe acidosis consisted of acute respiratory acidosis from ventilation-perfusion mismatch and acute metabolic acidosis resulting from bronchospasm and hypoxia-related lactic acidosis, respectively. The lactate level was normalized in 6\u00a0h after hypoxemia and ventilation correction. Given the lactate level re-elevated into a peak of 4.6\u00a0mmol\/L without signs of tissue hypoxia nor other possible etiologies, the salbutamol toxicity was suspected and the inhaler was discontinued that contributed to rapid lactate clearance. The patient was safely discharged on the 6th day of admission.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The re-elevation of serum lactate in status asthmaticus patient who had been administrated with the vast amount of \u03b22-adrenergic agonist should be considered for salbutamol-induced lactic acidosis and promptly discontinued especially when there were no common potentials.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s12890-021-01404-x","type":"journal-article","created":{"date-parts":[[2021,1,12]],"date-time":"2021-01-12T12:12:36Z","timestamp":1610453556000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Salbutamol-induced lactic acidosis in status asthmaticus survivor"],"prefix":"10.1186","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5461-9448","authenticated-orcid":false,"given":"Vorakamol","family":"Phoophiboon","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parima","family":"Singhagowinta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sangdao","family":"Boonkaya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thitiwat","family":"Sriprasart","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,1,12]]},"reference":[{"issue":"24","key":"1404_CR1","doi-asserted-by":"publisher","first-page":"2309","DOI":"10.1056\/NEJMra1309483","volume":"371","author":"JA Kraut","year":"2014","unstructured":"Kraut JA, Madias NE. 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