Arterial blood gas analysis and dyselectrolytemia in acute exacerbation of COPD as a prognostic marker

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is a disease state characterized by airflow limitation that is not fully reversible. COPD is the umbrella term used to include three different respiratory conditions defined clinically as chronic bronchitis and pathologically as Emphysema and it also includes small airway disease. COPD patients mostly present with the features of acute respiratory infectionsbut there may be a number of metabolic derangements arising out of the disease process or as a consequence of the therapy instituted like hyponatremia, hypokalemia, elevated liver enzymes and blood urea. These abnormalities are very often missed and may contribute to morbidity and mortality, if overlooked. Objectives: To study the levels of hypoxemia and serum electrolytes like sodium and potassium in cases of acute exacerbation of COPD and to assess the significance of dyselectrolytemia, as a prognostic marker in these patients. Materials and methods: The study was undertaken from November 2014 to October 2016 among the patients attending, Victoria hospital and Bowring and Lady Curzon hospital attached to Bangalore Medical College and Research Institute, with acute exacerbation of COPD diagnosed clinically and by the pulmonary function tests. 50 patients with acute exacerbation of COPD and 50 disease free healthy controls were included in the study. The Statistical software SAS 9.2, SPSS 15.0, were used for the analysis of the data and Microsoft word and excel have been used to generate graphs, tables etc. Conclusion: Electrolyte abnormalities are most commonly seen in patients with COPD with acute exacerbation and carry very poor prognosis in this group of patients. Thus, overlooking of coexistant metabolic abnormalities may contribute to a great deal of mortality and morbidity in COPD patients during their acute exacerbation episodes. Keywords: pulmonary disease; COPD; dyselectrolytemia; acute exacerbation