Utility of Initial Arterial Blood Gas in Neuromuscular versus Non-Neuromuscular Acute Respiratory Failure in Intensive Care Unit Patients

Utility of Initial Arterial Blood Gas in Neuromuscular versus Non-Neuromuscular Acute Respiratory Failure in Intensive Care Unit Patients

Background: The arterial blood gas (ABG) parameters of patients admitted to intensive care units (ICUs) with acute neuromuscular respiratory failure (NMRF) and non-NMRF have not been defined or compared in the literature. Methods: We retrospectively collected the initial ABG parameters (pH, PaCO2, P...

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Published in:Journal of clinical medicine Vol. 11; no. 16; p. 4926
Main Authors: Abuzinadah, Ahmad R, Almalki, Asma Khaled, Almuteeri, Rinad Zuwaimel, Althalabi, Rahaf Hassan, Sahli, Hanin Abdullah, Hayash, Fatima Abdulrahman, Alrayiqi, Rahaf Hamed, Makkawi, Seraj, Maglan, Alaa, Alamoudi, Loujen O, Alamri, Noof M, Alsaati, Maha H, Alshareef, Aysha A, Aljereish, Sultan Saeed, Bamaga, Ahmed K, Alhejaili, Faris, Abulaban, Ahmad Abdulaziz, Alanazy, Mohammed H
Format: Journal Article
Language:English
Published: Switzerland MDPI AG 22-08-2022
MDPI
Subjects:
Amyotrophic lateral sclerosis
Asthma
Chronic obstructive pulmonary disease
Clinical medicine
Edema
Guillain-Barre syndrome
Heart failure
Hospitals
Hypoxia
Intensive care
Intubation
Military reserves
Myasthenia gravis
Patients
Pneumonia
Pulmonary embolisms
Pulmonary fibrosis
Respiratory failure
Sepsis
Statistical analysis
Ventilators
Saudi Arabia
Riyadh Saudi Arabia
neuromuscular
blood gas
myasthenia gravis
respiratory failure
Guillain–Barré syndrome
pulmonary
amyotrophic lateral sclerosis
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Summary:Background: The arterial blood gas (ABG) parameters of patients admitted to intensive care units (ICUs) with acute neuromuscular respiratory failure (NMRF) and non-NMRF have not been defined or compared in the literature. Methods: We retrospectively collected the initial ABG parameters (pH, PaCO2, PaO2, and HCO3) of patients admitted to ICUs with acute respiratory failure. We compared ABG parameter ranges and the prevalence of abnormalities in NMRF versus non-NMRF and its categories, including primary pulmonary disease (PPD) (chronic obstructive pulmonary disease, asthma, and bronchiectasis), pneumonia, and pulmonary edema. Results: We included 287 patients (NMRF, n = 69; non-NMRF, n = 218). The difference between NMRF and non-NMRF included the median (interquartile range (IQR)) of pH (7.39 (7.32−7.43), 7.33 (7.22−7.39), p < 0.001), PaO2 (86.9 (71.4−123), 79.6 (64.6−99.1) mmHg, p = 0.02), and HCO3 (24.85 (22.9−27.8), 23.4 (19.4−26.8) mmol/L, p = 0.006). We found differences in the median of PaCO2 in NMRF (41.5 mmHg) versus PPD (63.3 mmHg), PaO2 in NMRF (86.9 mmHg) versus pneumonia (74.3 mmHg), and HCO3 in NMRF (24.8 mmol/L) versus pulmonary edema (20.9 mmol/L) (all p < 0.01). NMRF compared to non-NMRF patients had a lower frequency of hypercarbia (24.6% versus 39.9%) and hypoxia (33.8% versus 50.5%) (all p < 0.05). NMRF compared to PPD patients had lower frequency of combined hypoxia and hypercarbia (13.2% versus 37.8%) but more frequently isolated high bicarbonate (33.8% versus 8.9%) (all p < 0.001). Conclusions: The ranges of ABG changes in NMRF patients differed from those of non-NMRF patients, with a greater reduction in PaO2 in non-NMRF than in NMRF patients. Combined hypoxemia and hypercarbia were most frequent in PPD patients, whereas isolated high bicarbonate was most frequent in NMRF patients.
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ISSN:2077-0383
2077-0383
DOI:10.3390/jcm11164926