Abstract

Hypoventilation produces or worsens respiratory acidosis in patients with hypercapnia due to acute exacerbations of chronic obstructive pulmonary disease (AECOPD). In these patients acid–base and hydroelectrolite balance are closely related. Aim of the present study was to evaluate acid–base and hydroelectrolite alterations in these subjects and the effect of non-invasive ventilation and pharmacological treatment. Materials and Methods: We analyzed 110 patients admitted to the Pulmonology Department at Government General Hospital, Kadapa, from January 2022 to December 2022, for hypercapnic AECOPD. On admission, all patients underwent history taking, full examination, and arterial blood gas analysis and received oxygen with nasal cannula or a venturi mask to preserve normal oxygen saturation, as well as received pharmacological treatment. NIV was started when patients had severe dyspnea, increased work of breathing, and respiratory acidosis despite optimum management. Result: The mean potassium of the patients who needed medical treatment only was 5.74±0.44 m E q/l and mean Sodium was 139.31±5.99 m E q/l, whereas the mean potassium for the other group was 6.34±0.59 m E q/l and mean Sodium was 137.23±6.22 m E q/l. The mean serum Bicarbonate of the group the need medical treatment only was 25.71±3.39 m E q/l. The mean serum Bicarbonate of the other group was 31.03±3.15 m E q/l. In table: 5, the Sodium and Potassium levels before treatment were 137.22±6.22 and 6.33±0.59 m Eq/l, respectively, and mean Sodium and Potassium levels after treatment were 135.38±5.79 and 5.48±0.58 m Eq/l, respectively. Conclusion: Higher smoking index and frequency, more frequent COPD exacerbations, higher heart rate and respiratory rate,lower serum electrolytes (Na & K),lower PH and PaO2/FiO2 can significantly indicate a more severe AECOPD and higher smoking index (SI), PaCO2, frequent AECOPD, or lower PaO2 and Pao2/FiO2 can be used as independent predictors for the need for NIV.

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