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Acid-Base Disorders in COVID-19 Patients with Acute Respiratory Distress Syndrome

Our aim was to investigate the distribution of acid-base disorders in patients with COVID-19 ARDS using both the Henderson–Hasselbalch and Stewart’s approach and to explore if hypoxemia can influence acid-base disorders. COVID-19 ARDS patients, within the first 48 h of the need for a non-invasive re...

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Autores principales: Chiumello, Davide, Pozzi, Tommaso, Fratti, Isabella, Modafferi, Leo, Montante, Marialaura, Papa, Giuseppe Francesco Sferrazza, Coppola, Silvia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9024702/
https://www.ncbi.nlm.nih.gov/pubmed/35456186
http://dx.doi.org/10.3390/jcm11082093
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author Chiumello, Davide
Pozzi, Tommaso
Fratti, Isabella
Modafferi, Leo
Montante, Marialaura
Papa, Giuseppe Francesco Sferrazza
Coppola, Silvia
author_facet Chiumello, Davide
Pozzi, Tommaso
Fratti, Isabella
Modafferi, Leo
Montante, Marialaura
Papa, Giuseppe Francesco Sferrazza
Coppola, Silvia
author_sort Chiumello, Davide
collection PubMed
description Our aim was to investigate the distribution of acid-base disorders in patients with COVID-19 ARDS using both the Henderson–Hasselbalch and Stewart’s approach and to explore if hypoxemia can influence acid-base disorders. COVID-19 ARDS patients, within the first 48 h of the need for a non-invasive respiratory support, were retrospectively enrolled. Respiratory support was provided by helmet continuous positive airway pressure (CPAP) or by non-invasive ventilation. One hundred and four patients were enrolled, 84% treated with CPAP and 16% with non-invasive ventilation. Using the Henderson–Hasselbalch approach, 40% and 32% of patients presented respiratory and metabolic alkalosis, respectively; 13% did not present acid-base disorders. Using Stewart’s approach, 43% and 33% had a respiratory and metabolic alkalosis, respectively; 12% of patients had a mixed disorder characterized by normal pH with a lower SID. The severe hypoxemic and moderate hypoxemic group presented similar frequencies of respiratory and metabolic alkalosis. The most frequent acid-base disorders were respiratory and metabolic alkalosis using both the Henderson–Hasselbalch and Stewart’s approach. Stewart’s approach detected mixed disorders with a normal pH probably generated by the combined effect of strong ions and weak acids. The impairment of oxygenation did not affect acid-base disorders.
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spelling pubmed-90247022022-04-23 Acid-Base Disorders in COVID-19 Patients with Acute Respiratory Distress Syndrome Chiumello, Davide Pozzi, Tommaso Fratti, Isabella Modafferi, Leo Montante, Marialaura Papa, Giuseppe Francesco Sferrazza Coppola, Silvia J Clin Med Article Our aim was to investigate the distribution of acid-base disorders in patients with COVID-19 ARDS using both the Henderson–Hasselbalch and Stewart’s approach and to explore if hypoxemia can influence acid-base disorders. COVID-19 ARDS patients, within the first 48 h of the need for a non-invasive respiratory support, were retrospectively enrolled. Respiratory support was provided by helmet continuous positive airway pressure (CPAP) or by non-invasive ventilation. One hundred and four patients were enrolled, 84% treated with CPAP and 16% with non-invasive ventilation. Using the Henderson–Hasselbalch approach, 40% and 32% of patients presented respiratory and metabolic alkalosis, respectively; 13% did not present acid-base disorders. Using Stewart’s approach, 43% and 33% had a respiratory and metabolic alkalosis, respectively; 12% of patients had a mixed disorder characterized by normal pH with a lower SID. The severe hypoxemic and moderate hypoxemic group presented similar frequencies of respiratory and metabolic alkalosis. The most frequent acid-base disorders were respiratory and metabolic alkalosis using both the Henderson–Hasselbalch and Stewart’s approach. Stewart’s approach detected mixed disorders with a normal pH probably generated by the combined effect of strong ions and weak acids. The impairment of oxygenation did not affect acid-base disorders. MDPI 2022-04-08 /pmc/articles/PMC9024702/ /pubmed/35456186 http://dx.doi.org/10.3390/jcm11082093 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
Chiumello, Davide
Pozzi, Tommaso
Fratti, Isabella
Modafferi, Leo
Montante, Marialaura
Papa, Giuseppe Francesco Sferrazza
Coppola, Silvia
Acid-Base Disorders in COVID-19 Patients with Acute Respiratory Distress Syndrome
title Acid-Base Disorders in COVID-19 Patients with Acute Respiratory Distress Syndrome
title_full Acid-Base Disorders in COVID-19 Patients with Acute Respiratory Distress Syndrome
title_fullStr Acid-Base Disorders in COVID-19 Patients with Acute Respiratory Distress Syndrome
title_full_unstemmed Acid-Base Disorders in COVID-19 Patients with Acute Respiratory Distress Syndrome
title_short Acid-Base Disorders in COVID-19 Patients with Acute Respiratory Distress Syndrome
title_sort acid-base disorders in covid-19 patients with acute respiratory distress syndrome
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9024702/
https://www.ncbi.nlm.nih.gov/pubmed/35456186
http://dx.doi.org/10.3390/jcm11082093
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