Global cerebral edema from hypercapnic respiratory acidosis and response to hyperosmolar therapy

Hypercapnic respiratory acidosis (HRA) causes cerebral vasodilation via perivascular extracellular pH changes.¹ Its ability to precipitate global cerebral edema (GCE) in the absence of acute brain injury is rare. Treatment in these reports involves mechanical ventilation.² We describe a rare case of HRA-induced GCE in a patient without brain injury and the efficacy of hyperosmolar treatment after mechanical ventilation failed.

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