January 2024 Critical Care Case of the Month: I See Tacoma

No abstract available. Manuscript truncated after first 150 words. History of Present Illness An 80-year-old man was admitted to the hospital for exacerbation of COPD. He has a history of emphysema and has been on Breo Ellipta and Spiriva Respimat. He became increasingly short of breath although he had no productive cough. Past Medical History, Social History and Family History He has a past medical history of right upper lobe resection for an adenocarcinoma of the lung and a history of coronary artery bypass grafting and aortic valve replacement done about 5 years ago. He smoked ½ pack/day of cigarettes but quit 5 years ago. Medications He takes Warfarin for a history of atrial fibrillation and prosthetic aortic valve replacement. Physical Examination Other than dyspnea with tachypnea and decreased air movement on auscultation, as well as the expected right thoracic scar, his physical examination is unremarkable. Laboratory His arterial blood gases showed a PaO2 of 58, a PaCO2 of …