Case presentation: A 21-year-old, physically active man reported to the emergency room with shortness of breath and weakness in his legs, both of which had set in within an hour of physical exercise. Medical history: Not significant Medical examination at arrival: BP – 168/99 mm Hg HR – 100/min Saturation: 99% Temperature: 37.6 ˚C Glassgow coma scale (GCS) – E4M6V4 MRC muscle power scale (all extremities) – 4/5 Soon after the arrival: The patient collapsed from progressive respiratory distress and rapid desaturation GCS – E1M1V1 Cardiac output – Maintained The patient was intubated with etomidate and succinylcholine Severe respiratory acidosis – pH – 6.91 PCO2 – 167 mm Hg PO2 – 53 mm Hg SO2 – 55.2% Base excess – 0.5 mmol/L HCO3- - 17.7 mmol/L Glucose – 9.5 mmol/L Lactate – 1.0 mmol/L On extubation after 10 minutes of endotracheal intubation: Patient regained consciousness Could…