Our aim was to investigate the distribution of acid-base disorders in patients with COVID-19 ARDS using both the Henderson-Hasselbalch and Stewart's approach and to explore if hypoxemia can influence acid-base disorders. COVID-19 ARDS patients, within the first 48 h of the need for a non-invasive respiratory support, were retrospectively enrolled. Respiratory support was provided by helmet continuous positive airway pressure (CPAP) or by non-invasive ventilation. One hundred and four patients were enrolled, 84% treated with CPAP and 16% with non-invasive ventilation. Using the Henderson-Hasselbalch approach, 40% and 32% of patients presented respiratory and metabolic alkalosis, respectively; 13% did not present acid-base disorders. Using Stewart's approach, 43% and 33% had a respiratory and metabolic alkalosis, respectively; 12% of patients had a mixed disorder characterized by normal pH with a lower SID. The severe hypoxemic and moderate hypoxemic group presented similar frequencies of respiratory and metabolic alkalosis. The most frequent acid-base disorders were respiratory and metabolic alkalosis using both the Henderson-Hasselbalch and Stewart's approach. Stewart's approach detected mixed disorders with a normal pH probably generated by the combined effect of strong ions and weak acids. The impairment of oxygenation did not affect acid-base disorders.

Acid-Base Disorders in COVID-19 Patients with Acute Respiratory Distress Syndrome / D. Chiumello, T. Pozzi, I. Fratti, L. Modafferi, M. Montante, G.F.S. Papa, S. Coppola. - In: JOURNAL OF CLINICAL MEDICINE. - ISSN 2077-0383. - 11:8(2022 Apr), pp. 2093.1-2093.12. [10.3390/jcm11082093]

Acid-Base Disorders in COVID-19 Patients with Acute Respiratory Distress Syndrome

D. Chiumello
Primo
;
T. Pozzi;I. Fratti;L. Modafferi;M. Montante;G.F.S. Papa;S. Coppola
Ultimo
2022

Abstract

Our aim was to investigate the distribution of acid-base disorders in patients with COVID-19 ARDS using both the Henderson-Hasselbalch and Stewart's approach and to explore if hypoxemia can influence acid-base disorders. COVID-19 ARDS patients, within the first 48 h of the need for a non-invasive respiratory support, were retrospectively enrolled. Respiratory support was provided by helmet continuous positive airway pressure (CPAP) or by non-invasive ventilation. One hundred and four patients were enrolled, 84% treated with CPAP and 16% with non-invasive ventilation. Using the Henderson-Hasselbalch approach, 40% and 32% of patients presented respiratory and metabolic alkalosis, respectively; 13% did not present acid-base disorders. Using Stewart's approach, 43% and 33% had a respiratory and metabolic alkalosis, respectively; 12% of patients had a mixed disorder characterized by normal pH with a lower SID. The severe hypoxemic and moderate hypoxemic group presented similar frequencies of respiratory and metabolic alkalosis. The most frequent acid-base disorders were respiratory and metabolic alkalosis using both the Henderson-Hasselbalch and Stewart's approach. Stewart's approach detected mixed disorders with a normal pH probably generated by the combined effect of strong ions and weak acids. The impairment of oxygenation did not affect acid-base disorders.
ARDS; COVID-19; acid-base disorders; non-invasive ventilation
Settore MED/41 - Anestesiologia
8-apr-2022
Article (author)
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/949519
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