Tacx A N, Strack Van Schijndel R J
VU Medisch Centrum, afd. Inwendige Geneeskunde, De Boelelaan 1117, 1081 HV Amsterdam.
Ned Tijdschr Geneeskd. 2003 Sep 6;147(36):1747-9.
In a 75-year-old man who had experienced a serious nosebleed, as a consequence of collapsing, the nose was packed bilaterally. An evaluation of the dyspnoeic complaints revealed abnormal blood gas values which indicated hypoxemia. Ventilation perfusion scintigraphy and a lung function test did not reveal any abnormalities. Prior to additional investigations, the packing was removed and then the complaints disappeared and the blood gas values returned to normal. That nose packing can lead to arterial hypoxemia, with or without hypercapnia, has already been described. The underlying mechanism is probably determined multifactorially and is not completely clear. Control of the oxygen saturation seems to be indicated for patients with packing, and nasal obstruction should be considered in the differential diagnosis of hypoxemia.
