Usefulness of daytime arterial blood gases in detection of nocturnal respiratory acidosis in COPD patients undergoing LTOT
J. Tárrega, A. Antón, R. Güell, E. Farrero, S. Martí, M. Mayos, E. Prats, X. Muñoz, J. Sanchis (Barcelona, Spain)
Source: Annual Congress 2002 - Monitoring respiratory parameters in critically ill patients
Disease area: Airway diseases, Respiratory critical care, Sleep and breathing disorders
Abstract OBJECTIVE: To analyse the usefulness of daytime arterial blood gases (ABG) to detect oxygen-induced nocturnal respiratory acidosis in stable COPD patients. MATERIAL AND METHODS: Thirty-seven stable COPD patients with conventional criteria for LTOT were studied. ABG samples were obtained with the patient asleep and during sleep, both breathing room air and under oxygen therapy. Oxygen flow was set to keep SpO2 >= 90% while the patients rested during the day and, once titrated, it was not subsequently modified throughout the study period. RESULTS: All patients had severe CAFL (mean FEV1 25 ±] 8% of reference value) and hypercapnic respiratory failure (mean PaO2 55 ±] 6 and PaCO2 53 ±] 6 mm Hg). Mean oxygen flow administered was 1.36 ±] 0.45 L/min. Nocturnal respiratory acidosis was observed in 17 patients. Statistical significance was observed between daytime PaCO2 and pH, and nocturnal respiratory acidosis.
Room air Respiratory acidosis No Respiratory acidosis PaO2 (mmHg) 54 ±]7 56 ±]5 PaCO2 (mmHg) 55±]6* 51±]6 pH 7.38±]0.031* 7.41±]0.031 With O2 PaO2 74±]12 70±]7 PaCO2 57±]8* 51±]5 pH 7.37±]0.026* 7.39±]0.034
*p<0.05 CONCLUSION: Stable COPD patients undergoing LTOT with higher daytime PaCO2 and lower daytime pH, both breathing room air and during oxygen administration, have a tendency to develop nocturnal respiratory acidosis.
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J. Tárrega, A. Antón, R. Güell, E. Farrero, S. Martí, M. Mayos, E. Prats, X. Muñoz, J. Sanchis (Barcelona, Spain). Usefulness of daytime arterial blood gases in detection of nocturnal respiratory acidosis in COPD patients undergoing LTOT. Eur Respir J 2002; 20: Suppl. 38, 628
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