TY - JOUR
T1 - Post-hypercapnic alkalosis is associated with ventilator dependence and increased ICU stay
AU - Banga, Amit
AU - Khilnani, G. C.
PY - 2009
Y1 - 2009
N2 - Posthypercapnic alkalosis (PHA) is frequently overlooked as a complication of mechanical ventilation in patients with exacerbation of chronic obstructive pulmonary disease (COPD). The current study was conducted to determine the incidence, risk factors for development and effect on outcome of PHA. Eighty-four patients (62 ± 11 years, range 4278 years, M:F 58: 26) with exacerbation of COPD with underlying chronic hypercapnic respiratory failure requiring mechanical ventilation were included in a retrospective fashion. PHA was defined as static or rising serum bicarbonate levels, 72 hours or more after return of PaCO2 to baseline, with concurrent pH > 7.44. Development of PHA was noted in 17 patients (20.2). Corticosteroid use ≥10 days during the hospital stay was an independent risk factor for development of PHA (Adjusted OR, 95 CI: 9.4, 1.655.3; P 0.013). Development of PHA was associated with an increased incidence of ventilator dependence (64.7 vs. 37.3, OR, 95 CI: 3.1, 1.19.4, P 0.04) and duration of ICU stay (14.7 ± 6.7 vs. 9.5 ± 5.9, P 0.01) but no increase in hospital mortality (43.3 vs. 41.2, P NS). It is concluded that PHA is a common complication in patients with exacerbation of COPD requiring mechanical ventilation and is associated with increased incidence of ventilator dependence and ICU stay.
AB - Posthypercapnic alkalosis (PHA) is frequently overlooked as a complication of mechanical ventilation in patients with exacerbation of chronic obstructive pulmonary disease (COPD). The current study was conducted to determine the incidence, risk factors for development and effect on outcome of PHA. Eighty-four patients (62 ± 11 years, range 4278 years, M:F 58: 26) with exacerbation of COPD with underlying chronic hypercapnic respiratory failure requiring mechanical ventilation were included in a retrospective fashion. PHA was defined as static or rising serum bicarbonate levels, 72 hours or more after return of PaCO2 to baseline, with concurrent pH > 7.44. Development of PHA was noted in 17 patients (20.2). Corticosteroid use ≥10 days during the hospital stay was an independent risk factor for development of PHA (Adjusted OR, 95 CI: 9.4, 1.655.3; P 0.013). Development of PHA was associated with an increased incidence of ventilator dependence (64.7 vs. 37.3, OR, 95 CI: 3.1, 1.19.4, P 0.04) and duration of ICU stay (14.7 ± 6.7 vs. 9.5 ± 5.9, P 0.01) but no increase in hospital mortality (43.3 vs. 41.2, P NS). It is concluded that PHA is a common complication in patients with exacerbation of COPD requiring mechanical ventilation and is associated with increased incidence of ventilator dependence and ICU stay.
KW - COPD exacerbation
KW - Outcomes
KW - Post-hypercapnic alkalosis
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U2 - 10.3109/15412550903341448
DO - 10.3109/15412550903341448
M3 - Article
C2 - 19938966
AN - SCOPUS:73549115885
SN - 1541-2555
VL - 6
SP - 437
EP - 440
JO - COPD: Journal of Chronic Obstructive Pulmonary Disease
JF - COPD: Journal of Chronic Obstructive Pulmonary Disease
IS - 6
ER -