Arterial Blood Gas Analysis and Dyselectrolytemia in Acute Exacerbation of Chronic Obstructive Pulmonary Disease (COPD)
DOI:
https://doi.org/10.15850/ijihs.v13n2.4565Keywords:
Chronic obstructive pulmonary disease, electrolyte imbalance, hypokalemia, hyponatremia, respiratory acidosisAbstract
Background: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) is one of the important causes of morbidity, mortality, and healthcare burden. Electrolyte disturbances and acid–base imbalances are frequent but under-recognized complications that may worsen outcomes in cases of AECOPD.
Objective: To understand the prevalence of serum electrolyte abnormalities and arterial blood gas (ABG) parameters in patients admitted with AECOPD.
Methods: This prospective observational study enrolled 200 patients with confirmed AECOPD admitted to a tertiary care hospital in Kalaburagi, India, over an 18 month period. The ABG analysis and serum electrolytes (sodium, potassium, magnesium, chloride) measurement were performed at admission. Demographic, clinical, and radiological data were also collected. Data were then analyzed using SSPS 23.0, with a P value of < 0.05 considered statistically significant.
Results: Abnormalities related to sodium (91.5%), potassium (90.5%), magnesium (80.5%), and chloride (56%) were common in cases admitted with AECOPD. In 45% cases, the PaOâ‚‚ <50 mmHg was seen whereas PaCOâ‚‚ >45 mmHg was found in 43%. Acid–base imbalance was seen in 35% cases, with 4.5% showing severe acidosis (pH ≤7.1). Cough (72.5%) and breathlessness (60.5%) were most common symptoms. The majority were elderly males (65%) whereas 57% were smokers. Diabetes was the most common comorbidity (30.5%).
Conclusion: Electrolyte abnormalities and ABG derangements are nearly universal in AECOPD and have important prognostic implications. Routine metabolic profiling should be integrated into the acute management of COPD to improve outcomes, particularly in resource-constrained settings.
References
- Boers E, Barrett M, Su JG, Benjafield AV, Sinha S, et al. Global burden of chronic obstructive pulmonary disease through 2050. JAMA Netw Open. 2023;6(12):e2346598. doi:10.1001/jamanetworkopen.2023.46598
- Hussaini M, Minhaj R, Aishwarya N, Kurapati M, Al Khatib Y, et al. Analysis of pH, electrolytes and non-invasive respiratory support in COPD with elevated CO2. Bioinformation. 2024;20(11):1503–7. doi:10.6026/9732063002001503
- Deep A, Behera PR, Subhankar S, Rajendran A, Rao CM. Serum electrolytes in patients presenting with acute exacerbation of chronic obstructive pulmonary disease (COPD) and their comparison with stable COPD patients. Cureus. 2023;15(4):e38080. doi:10.7759/cureus.38080
- Tongyoo S, Viarasilpa T, Permpikul C. Serum potassium levels and outcomes in critically ill patients in the medical intensive care unit. J Int Med Res. 2018;46(3):1254–62. doi:10.1177/0300060517744427
- MartÃnez-Gestoso S, GarcÃa-Sanz MT, Carreira JM, Nieto-Fontarigo JJ, Calvo-Ãlvarez U, et al. Prognostic usefulness of basic analytical data in chronic obstructive pulmonary disease exacerbation. Open Respir Arch. 2023;5(4):100271. doi:10.1016/j.opresp.2023.100271
- Lindner G, Herschmann S, Funk GC, Exadaktylos AK, Gygli R, et al. Sodium and potassium disorders in patients with COPD exacerbation presenting to the emergency department. BMC Emerg Med. 2022;22(1):49. doi:10.1186/s12873-022-00607-7
- GarcÃa-Sanz MT, MartÃnez-Gestoso S, Calvo-Ãlvarez U, Doval-Oubiña L, Camba-Matos S, et al. Impact of hyponatremia on COPD exacerbation prognosis. J Clin Med. 2020;9(2):503. doi:10.3390/jcm9020503
- Csoma B, Vulpi MR, Dragonieri S, Bentley A, Felton T, Lázár Z, et al. Hypercapnia in COPD: causes, consequences, and therapy. J Clin Med. 2022;11(11):3180. doi:10.3390/jcm11113180
- Slenter RH, Sprooten RT, Kotz D, Wesseling G, Wouters EF, Rohde GG. Predictors of 1-year mortality at hospital admission for acute exacerbations of chronic obstructive pulmonary disease. Respiration. 2013;85(1):15–26. doi:10.1159/000342036
- Sreekumar A, Velayudhan KK. Role of serum magnesium in acute exacerbations of chronic obstructive pulmonary disease. Int J Adv Med. 2021;8:505–10. doi:10.18203/2349-3933.ijam20210687
- Kılıç H, Kanbay A, Karalezlı A, Babaoglu E, Hasanoglu HC, et al. The relationship between hypomagnesemia and pulmonary function tests in patients with chronic asthma. Med Princ Pract. 2018;27(2):139–44. doi:10.1159/000487760
- Ouf FM, Abdel Aziz AF, Wahba AH, et al. Electrolyte disturbances and their impact on mechanically ventilated patients with acute exacerbation of chronic obstructive pulmonary disease. Al-Azhar Assiut Med J. 2015;13:27–33.
- Shao M, Li G, Sarvottam K, Wang S, Thongprayoon C, et al. Dyschloremia is a risk factor for the development of acute kidney injury in critically ill patients. PLoS One. 2016;11(8):e0160322. doi:10.1371/journal.pone.0160322
- Salvi SS, Barnes PJ. Chronic obstructive pulmonary disease in non-smokers. Lancet. 2009;374(9691):733–43. doi:10.1016/S0140-6736(09)61303-9
- López-Campos JL, Tan W, Soriano JB. Global burden of COPD. Respirology. 2016;21(1):14–23. doi:10.1111/resp.12660
Downloads
Published
Issue
Section
License
Authors retain copyright and grant International Journal of Integrated Health Sciences right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to freely share and remix the work with an acknowledgement of the work's authorship and initial publication in International Journal of Integrated Health Sciences.