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A reversible cause of refractory hypoxaemia
  1. O Hugli,
  2. S Cook
  1. Department of Internal Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
  1. Correspondence to:
    Dr O Hugli, Department of Internal Medicine, Centre Interdisciplinaire des Urgences, CHUV, BH 17-303, 1011 Lausanne, Switzerland;

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A 73 year old man, with a medical history of coronary artery disease, called the ambulance, because of retrosternal chest pain. When the paramedics arrived, his initial vital signs were normal and a pulse oximetry (Spo2) was 94% on room air as he layed supine in bed. The pain persisted after sublingual nitroglycerin administration, and he was transported to hospital. While he was lying in a semi-recumbent position on the ambulance stretcher, his Spo2 decreased to 70% and, despite receiving 100% oxygen through a face mask with an oxygen reservoir and oxygen flow of 12 l/min, it only rose to 80%. On arrival at the emergency department, the patient complained of shortness of breath, …

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