Mixed acid-base disorders, hydroelectrolyte imbalance and lactate production in hypercapnic respiratory failure: The role of noninvasive ventilation

Claudio Terzano, Fabio Di Stefano, Vittoria Conti, Marta Di Nicola, Gregorino Paone, Angelo Petroianni, Alberto Ricci

Research output: Contribution to journalArticle

Abstract

Background: Hypercapnic Chronic Obstructive Pulmonary Disease (COPD) exacerbation in patients with comorbidities and multidrug therapy is complicated by mixed acid-base, hydro-electrolyte and lactate disorders. Aim of this study was to determine the relationships of these disorders with the requirement for and duration of noninvasive ventilation (NIV) when treating hypercapnic respiratory failure. Methods: Sixty-seven consecutive patients who were hospitalized for hypercapnic COPD exacerbation had their clinical condition, respiratory function, blood chemistry, arterial blood gases, blood lactate and volemic state assessed. Heart and respiratory rates, pH, PaO 2 and PaCO 2 and blood lactate were checked at the 1st, 2nd, 6th and 24th hours after starting NIV. Results: Nine patients were transferred to the intensive care unit. NIV was performed in 11/17 (64.7%) mixed respiratory acidosis-metabolic alkalosis, 10/36 (27.8%) respiratory acidosis and 3/5 (60%) mixed respiratory-metabolic acidosis patients (p = 0.026), with durations of 45.1±9.8, 36.2±8.9 and 53.3±4.1 hours, respectively (p = 0.016). The duration of ventilation was associated with higher blood lactate (p

Original languageEnglish
Article numbere35245
JournalPLoS One
Volume7
Issue number4
DOIs
Publication statusPublished - Apr 23 2012

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

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