The prognostic value of hypophosphatemia in acute exacerbation of chronic obstructive pulmonary disease (COPD)

IF 0.3 Q4 CRITICAL CARE MEDICINE Egyptian Journal of Critical Care Medicine Pub Date : 2017-08-01 DOI:10.1016/j.ejccm.2017.04.001
Ibrahim El-Sayed , Mohammed El-Dosouky , Karim Mashhour , Suzy Fawzy
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引用次数: 4

Abstract

Background

Phosphorus (P) is an important electrolyte that plays a significant role in different physiological processes especially muscle contraction and adenosine triphosphate (ATP) high energy bonds. Low phosphorus level in blood may increase the exacerbation of chronic obstructive pulmonary disease (COPD), need, and duration of mechanical ventilation (MV).

Work aim

This study aims to examine and evaluate the effect of low serum phosphorus level on patients admitted with acute exacerbation of COPD regarding the need for ventilation, duration of ventilation and outcome.

Methods

We studied fifty patients with acute exacerbation of COPD admitted to chest department and respiratory ICU at Benha University hospital in the period between October 2014 and March 2015. A comparison was made between the group (A) with low phosphorus (<2.5 mg/dl) and group (B) with normal blood phosphorus (2.5–4.5 mg/dl), serum phosphorus was measured on admission. SIMV mode was the mode of MV in all patients.

Results

Sixty percent of the included patients had low levels of phosphorus while 40% had normal phosphorus level, 25 patients (83.3%) of hypophosphatemic group needed MV and 5 patients (16.7%) didn’t need MV, while in the normal phosphorus group, 11 patients (55%) needed MV and 9 patients (45%) didn’t need MV (P:0.032).

Regarding outcome, 18 patients (60%) with hypophosphatemia were discharged while 12 patients (40%) failed to wean and died. In normal phosphorus group, 14 patients (70%) discharged, but 6 patients (30%) failed to wean and died (P: 0.032), in patients with hypophosphatemia 10 patients had pneumonia with COPD, 5 patients of them needed MV and only one died, in patients with normal phosphorus level 7 patients had pneumonia, only one patient needed MV and died.

Conclusion

Hypophosphatemia may contribute to an increase in the COPD exacerbation, the need for ventilation, the duration of ventilation, and may contribute with other factors in increase in the rate of mortality. Therefore, monitoring and correcting its level is imperative.

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低磷血症在慢性阻塞性肺疾病(COPD)急性加重期的预后价值
磷(P)是一种重要的电解质,在不同的生理过程中,特别是肌肉收缩和三磷酸腺苷(ATP)高能键中起着重要作用。低血磷水平可能增加慢性阻塞性肺疾病(COPD)的加重、机械通气(MV)的需要和持续时间。本研究旨在探讨低血磷水平对COPD急性加重患者通气需求、通气持续时间及预后的影响。方法对2014年10月至2015年3月在滨海大学附属医院胸科及呼吸内科ICU收治的急性加重期COPD患者50例进行研究。将低磷组(2.5 mg/dl)与正常血磷组(2.5 ~ 4.5 mg/dl)进行比较,入院时测定血清磷。所有患者的MV均为SIMV模式。结果低磷患者占60%,正常磷患者占40%,低磷组有25例(83.3%)需要中毒者,5例(16.7%)不需要中毒者,而正常磷组有11例(55%)需要中毒者,9例(45%)不需要中毒者(P:0.032)。结果方面,18例(60%)低磷血症患者出院,12例(40%)未能断奶死亡。磷正常组14例(70%)出院,6例(30%)未断奶死亡(P: 0.032),低磷血症组10例肺炎合并COPD, 5例需要MV, 1例死亡,磷正常组7例肺炎,1例需要MV, 1例死亡。结论低磷血症可能与COPD加重、通气需要、通气时间增加有关,并可能与其他因素共同导致死亡率升高。因此,监测和纠正其水平势在必行。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
自引率
0.00%
发文量
5
审稿时长
42 weeks
期刊介绍: The Egyptian Journal of Critical Care Medicine is the official Journal of the Egyptian College of Critical Care Physicians, the most authoritative organization of Egyptian physicians involved in the multi-professional field of critical care medicine. The journal is intended to provide a peer-reviewed source for multidisciplinary coverage of general acute and intensive care medicine and its various subcategories including cardiac, pulmonary, neuro, renal as well as post-operative care. The journal is proud to have an international multi-professional editorial board in the broad field of critical care that will assist in publishing promising research and breakthrough reports that lead to better patients care in life threatening conditions, and bring the reader a quick access to the latest diagnostic and therapeutic approaches in monitoring and management of critically ill patients.
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