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Chronic obstructive pulmonary disease admitted to an intensive care unit because of acute respiratory failure: How do severity of acidosis effect short and long term mortality?

Feyza Kargin, Ilim Irmak, Fulya Çiyiltepe, Sinem Güngör, Eylem Acartürk, Huriye Berk Takir, Pinar Atagün Güney, Özlem Yaziicioglu Moçin, Nalan Adigüzel, Zuhal Karakurt
European Respiratory Journal 2016 48: PA3060; DOI: 10.1183/13993003.congress-2016.PA3060
Feyza Kargin
1Respiratory Intensive Care Unit, Ureyyapasa Chest Diseases and Thoracic Surgery Teaching and Research Hospital, Istanbul, Turkey
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Ilim Irmak
1Respiratory Intensive Care Unit, Ureyyapasa Chest Diseases and Thoracic Surgery Teaching and Research Hospital, Istanbul, Turkey
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Fulya Çiyiltepe
1Respiratory Intensive Care Unit, Ureyyapasa Chest Diseases and Thoracic Surgery Teaching and Research Hospital, Istanbul, Turkey
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Sinem Güngör
1Respiratory Intensive Care Unit, Ureyyapasa Chest Diseases and Thoracic Surgery Teaching and Research Hospital, Istanbul, Turkey
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Eylem Acartürk
1Respiratory Intensive Care Unit, Ureyyapasa Chest Diseases and Thoracic Surgery Teaching and Research Hospital, Istanbul, Turkey
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Huriye Berk Takir
1Respiratory Intensive Care Unit, Ureyyapasa Chest Diseases and Thoracic Surgery Teaching and Research Hospital, Istanbul, Turkey
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Pinar Atagün Güney
1Respiratory Intensive Care Unit, Ureyyapasa Chest Diseases and Thoracic Surgery Teaching and Research Hospital, Istanbul, Turkey
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Özlem Yaziicioglu Moçin
1Respiratory Intensive Care Unit, Ureyyapasa Chest Diseases and Thoracic Surgery Teaching and Research Hospital, Istanbul, Turkey
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Nalan Adigüzel
1Respiratory Intensive Care Unit, Ureyyapasa Chest Diseases and Thoracic Surgery Teaching and Research Hospital, Istanbul, Turkey
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Zuhal Karakurt
1Respiratory Intensive Care Unit, Ureyyapasa Chest Diseases and Thoracic Surgery Teaching and Research Hospital, Istanbul, Turkey
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Abstract

Aim: Effect of the severity of respiratory acidosis on short and long term survival in chronic obstructive pulmonary disease (COPD) patients is investigated in this study.

Methods: Retrospective, observational cohort study in a intensive care unit (ICU) of a chest diseases hospital from January-December 2014. Acute respiratory failure(ARF) and COPD patients were included to study. Patients were divided into two groups according to ICU admission arterial blood gas values; ph≤7.20 (group1) and pH:7.21-7.34(group 2).Patients characteristics, ICU parameters, ICU mortality, short (28 days ) and long term (12 months) mortality were recorded.

Results: 312 COPD patients were enrolled. Study groups were group 1 (n=69 ) and group 2 (n=243). Groups demographics were similar. Length of ICU stay and ICU mortality were similar in two groups.28 day mortality was %13.1 and %10.6 (p=0.35),1 year mortality 29.5% ve 36 % (p=0.35 ) in group 1 and 2 respectively. In cox regression analysis, hazard ratio of 1 year mortality was associated with presence of septic shock (HR:2.1,CI:1-4.5, p=0.039), presence of domiciliary noninvasive mechanical ventilation(DNIMV) before ICU(HR:2.5, CI:1-5.9, p=0.03), severe acidosis (HR:0.42,CI:0.5-3.03, P=0.51) and DNIMV prescription after ICU discharge(HR:0.4,CI:0.17-0.9, p=0.035).

Conclusions: Severity of acidosis (pH< 7.20) does not affect short and long term mortality. Septic shock during ICU and pre ICU presence of DNIMV found to be a risk factor for 1 year mortality therefore should be followed closely. Also prescription of DNIMVafter ICU discharge decreases long term mortality significantly.

  • COPD - exacerbations
  • Acute respiratory failure
  • Non-invasive ventilation - long-term
  • Copyright ©the authors 2016
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Chronic obstructive pulmonary disease admitted to an intensive care unit because of acute respiratory failure: How do severity of acidosis effect short and long term mortality?
Feyza Kargin, Ilim Irmak, Fulya Çiyiltepe, Sinem Güngör, Eylem Acartürk, Huriye Berk Takir, Pinar Atagün Güney, Özlem Yaziicioglu Moçin, Nalan Adigüzel, Zuhal Karakurt
European Respiratory Journal Sep 2016, 48 (suppl 60) PA3060; DOI: 10.1183/13993003.congress-2016.PA3060

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Chronic obstructive pulmonary disease admitted to an intensive care unit because of acute respiratory failure: How do severity of acidosis effect short and long term mortality?
Feyza Kargin, Ilim Irmak, Fulya Çiyiltepe, Sinem Güngör, Eylem Acartürk, Huriye Berk Takir, Pinar Atagün Güney, Özlem Yaziicioglu Moçin, Nalan Adigüzel, Zuhal Karakurt
European Respiratory Journal Sep 2016, 48 (suppl 60) PA3060; DOI: 10.1183/13993003.congress-2016.PA3060
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