Hypo- and hypercapnia predict mortality in oxygen-dependent chronic obstructive pulmonary disease: a population-based prospective study

Respiratory Research

Magnus P Ekström¹  Bengt Midgren¹  Karl A Franklin³  Anna Bornefalk-Hermansson⁴  Zainab Ahmadi² 

[1] Department of Clinical Sciences, Lund, Division of Respiratory Medicine & Allergology, Lund University Hospital, Lund, Sweden;Department of Medicine, Blekinge Hospital, 37185 Karlskrona, Sweden;Department of Surgical and Perioperative Sciences, Surgery, University Hospital of Umeå, Umeå, Sweden;Uppsala Clinical Research Center, Uppsala University Hospital, Uppsala, Sweden

关键词: Survival;    Respiratory failure;    Carbon dioxide;    Hypercapnia;    PaCO₂;    Mortality;    LTOT;    COPD;   

Others  :  790374
DOI  :  10.1186/1465-9921-15-30

 received in 2013-09-04, accepted in 2014-03-06,  发布年份 2014

【 摘 要 】

Background

The prognostic role of the arterial blood gas tension of carbon dioxide (PaCO₂) in severe Chronic Obstructive Pulmonary Disease (COPD) remains unknown. The aim of this study was to estimate the association between PaCO₂ and mortality in oxygen-dependent COPD.

Methods

National prospective study of patients starting long-term oxygen therapy (LTOT) for COPD in Sweden between October 1, 2005 and June 30, 2009, with all-cause mortality as endpoint. The association between PaCO₂ while breathing air, PaCO₂ (air), and mortality was estimated using Cox regression adjusted for age, sex, arterial blood gas tension of oxygen (PaO₂), World Health Organization performance status, body mass index, comorbidity, and medications.

Results

Of 2,249 patients included, 1,129 (50%) died during a median 1.1 years (IQR 0.6-2.0 years) of observation. No patient was lost to follow-up. PaCO₂ (air) independently predicted adjusted mortality (p < 0.001). The association with mortality was U-shaped, with the lowest mortality at approximately PaCO₂ (air) 6.5 kPa and increased mortality at PaCO₂ (air) below 5.0 kPa and above 7.0 kPa.

Conclusion

In oxygen-dependent COPD, PaCO₂ (air) is an independent prognostic factor with a U-shaped association with mortality.

【 授权许可】

   
2014 Ahmadi et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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