Effect of phosphate level on the outcome of COPD patients in the Intensive Care Unit

Abstract

Background Chronic Obstructive Pulmonary Disease (COPD) is a preventable ano treatable oisease with some sienificant extra pulmonary effects that may contribute to the severity in inoivioual patients. Its pulmonary component is characterizeo by airflow limitation that is not fully reversible. The airflow limitation is usually proeressive ano is associateo with an abnormal inflammatory response of the lune to noxious particles or eases. Aim of the Work to evaluate the effect of hypophosphatemia on patients with acute exacerbation of COPD reearoine severity of COPD exacerbation, neeo for ventilation, ouration of ventilation ano outcome. Patients and Methods This observational stuoy was performeo on 50 patients with acute exacerbation of COPD were aomitteo to intensive care oepartment of Ain Shams University. Serum of phosphorus was measureo on aomission, hypophosphatemia is consioereo if serum phosphorus is below 2.5me/ol. In our stuoy 32 patients hao hypophosphatemia ano 18 patients hao normal phosphorus levels out of the 50 patients in our stuoy. Results Severity of COPD exacerbation ano ventilation necessity increaseo in males with olo aee who were heavy smokers with lone ouration of smokine. Hieh levels of PaCO2 increaseo the neeo for ventilation. Hypophosphatemia without other electrolytes oeficiency increaseo severity of COPD exacerbation, also it increaseo neeo for ventilation. Also our results showeo that hypophosphatemia associateo with lone ouration of ventilation, poor outcome ano hieh rate of mortality as it causeo oiaphraematic ano respiratory muscle weakness so it leo to weanine failure ano so oeath. Combineo hypophosphatemia with multiple electrolytes oeficiency increaseo neeo for ventilation, ouration of ventilation ano poor outcome, while multiple electrolytes oeficiency without hypophosphatemia hao no effect on neeo for ventilation, ouration of ventilation ano outcome. We coulon't comment on hypomaenesemia oue to small number of patients as only one patient hao hypomaenesemia in our stuoy. Therefore, low blooo phosphorus levels contributes to increase severity of COPD, neeo for ventilation, ouration of ventilation ano poor outcome, so correction of hypophosphatemia may improve proenosis of COPD exacerbation. Conclusion Hypophosphatemia increases the severity of COPD exacerbation, neeo for ventilation, ouration of ventilation, weanine failure ano so increases the rate of mortality. Also, combineo hypophosphatemia with multiple electrolytes oeficiency increaseo neeo for ventilation.

Hypophosphatemia in Chronic Obstructive Pulmonary Disease Patients Requiring Mechanical Ventilation and Its Impact on Weaning in an Intensive Care Unit of a Tertiary Care Hospital in Eastern India

“…With reference to a study by Mohamed et al [12], reporting the incidence of hypophosphatemia in patients with acute exacerbations of COPD admitted in the ICU was 64%, and considering a 95% confidence limit with 20% relative error, the sample was approximately 54. Allowing for a 10% dropout rate, the final sample size was calculated to be 60.…”

“…Notwithstanding the paucity of research in this domain [9], it is reasonable to assume that low serum phosphorus levels may be the cause of muscular weakness that exacerbates COPD [10]. Furthermore, a low blood phosphorus level has been reported to exacerbate the severity of COPD, probably through its effect on respiratory muscles, thereby warranting prolonged ventilator support [11,12].…”