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Temporal Changes in the Oxyhemoglobin Dissociation Curve of Critically Ill COVID-19 Patients

Critical COVID-19 is a life-threatening disease characterized by severe hypoxemia with complex pathophysiological mechanisms that are not yet completely understood. A pathological shift in the oxyhemoglobin curve (ODC) was previously described through the analysis of p50, intended as the oxygen tens...

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Autores principales: Ceruti, Samuele, Minotti, Bruno, Glotta, Andrea, Biggiogero, Maira, Bona, Giovanni, Marzano, Martino, Greco, Pietro, Spagnoletti, Marco, Garzoni, Christian, Bendjelid, Karim
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8836951/
https://www.ncbi.nlm.nih.gov/pubmed/35160240
http://dx.doi.org/10.3390/jcm11030788
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author Ceruti, Samuele
Minotti, Bruno
Glotta, Andrea
Biggiogero, Maira
Bona, Giovanni
Marzano, Martino
Greco, Pietro
Spagnoletti, Marco
Garzoni, Christian
Bendjelid, Karim
author_facet Ceruti, Samuele
Minotti, Bruno
Glotta, Andrea
Biggiogero, Maira
Bona, Giovanni
Marzano, Martino
Greco, Pietro
Spagnoletti, Marco
Garzoni, Christian
Bendjelid, Karim
author_sort Ceruti, Samuele
collection PubMed
description Critical COVID-19 is a life-threatening disease characterized by severe hypoxemia with complex pathophysiological mechanisms that are not yet completely understood. A pathological shift in the oxyhemoglobin curve (ODC) was previously described through the analysis of p50, intended as the oxygen tension at which hemoglobin is saturated by oxygen at 50%. The aim of this study was to analyze Hb-O(2) affinity features over time in a cohort of critically ill COVID-19 patients, through the analysis of ODC p50 behavior. A retrospective analysis was performed; through multiple arterial blood gas (ABG) analyses, each p50 was calculated and normalized according to PaCO(2), pH and temperature; patients’ p50 evolution over time was reported, comparing the first 3 days (early p50s) with the last 3 days (late p50s) of ICU stay. A total of 3514 ABG analyses of 32 consecutive patients were analyzed. The majority of patients presented a left shift over time (p = 0.03). A difference between early p50s and late p50s was found (20.63 ± 2.1 vs. 18.68 ± 3.3 mmHg, p = 0.03); median p50 of deceased patients showed more right shifts than those of alive patients (24.1 vs. 18.45 mmHg, p = 0.01). One-way ANOVA revealed a p50 variance greater in the early p50s (σ(2) = 8.6) than in the late p50s (σ(2) = 3.84), associated with a reduction over time (p < 0.001). Comparing the Hb-O(2) affinity in critically ill COVID-19 patients between ICU admission and ICU discharge, a temporal shift in the ODC was observed.
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spelling pubmed-88369512022-02-12 Temporal Changes in the Oxyhemoglobin Dissociation Curve of Critically Ill COVID-19 Patients Ceruti, Samuele Minotti, Bruno Glotta, Andrea Biggiogero, Maira Bona, Giovanni Marzano, Martino Greco, Pietro Spagnoletti, Marco Garzoni, Christian Bendjelid, Karim J Clin Med Article Critical COVID-19 is a life-threatening disease characterized by severe hypoxemia with complex pathophysiological mechanisms that are not yet completely understood. A pathological shift in the oxyhemoglobin curve (ODC) was previously described through the analysis of p50, intended as the oxygen tension at which hemoglobin is saturated by oxygen at 50%. The aim of this study was to analyze Hb-O(2) affinity features over time in a cohort of critically ill COVID-19 patients, through the analysis of ODC p50 behavior. A retrospective analysis was performed; through multiple arterial blood gas (ABG) analyses, each p50 was calculated and normalized according to PaCO(2), pH and temperature; patients’ p50 evolution over time was reported, comparing the first 3 days (early p50s) with the last 3 days (late p50s) of ICU stay. A total of 3514 ABG analyses of 32 consecutive patients were analyzed. The majority of patients presented a left shift over time (p = 0.03). A difference between early p50s and late p50s was found (20.63 ± 2.1 vs. 18.68 ± 3.3 mmHg, p = 0.03); median p50 of deceased patients showed more right shifts than those of alive patients (24.1 vs. 18.45 mmHg, p = 0.01). One-way ANOVA revealed a p50 variance greater in the early p50s (σ(2) = 8.6) than in the late p50s (σ(2) = 3.84), associated with a reduction over time (p < 0.001). Comparing the Hb-O(2) affinity in critically ill COVID-19 patients between ICU admission and ICU discharge, a temporal shift in the ODC was observed. MDPI 2022-01-31 /pmc/articles/PMC8836951/ /pubmed/35160240 http://dx.doi.org/10.3390/jcm11030788 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Ceruti, Samuele
Minotti, Bruno
Glotta, Andrea
Biggiogero, Maira
Bona, Giovanni
Marzano, Martino
Greco, Pietro
Spagnoletti, Marco
Garzoni, Christian
Bendjelid, Karim
Temporal Changes in the Oxyhemoglobin Dissociation Curve of Critically Ill COVID-19 Patients
title Temporal Changes in the Oxyhemoglobin Dissociation Curve of Critically Ill COVID-19 Patients
title_full Temporal Changes in the Oxyhemoglobin Dissociation Curve of Critically Ill COVID-19 Patients
title_fullStr Temporal Changes in the Oxyhemoglobin Dissociation Curve of Critically Ill COVID-19 Patients
title_full_unstemmed Temporal Changes in the Oxyhemoglobin Dissociation Curve of Critically Ill COVID-19 Patients
title_short Temporal Changes in the Oxyhemoglobin Dissociation Curve of Critically Ill COVID-19 Patients
title_sort temporal changes in the oxyhemoglobin dissociation curve of critically ill covid-19 patients
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8836951/
https://www.ncbi.nlm.nih.gov/pubmed/35160240
http://dx.doi.org/10.3390/jcm11030788
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