The features of AECOPD with carbon dioxide retention

Abstract

BackgroundChronic obstructive pulmonary disease (COPD) with carbon dioxide retention is associated with a worsening clinical condition and the beginning of pulmonary ventilation decompensation. This study aimed to identify the factors associated with carbon dioxide retention.MethodsThis was a retrospective study of consecutive patients with COPD (meeting the Global Initiative for Chronic Obstructive Lung Disease diagnostic criteria) hospitalized at The Ninth Hospital of Xi’an Affiliated Hospital of Xi’an Jiaotong University between October 2014 and September 2017. The baseline demographic, clinical, laboratory, pulmonary function, and imaging data were compared between the 86 cases with carbon dioxide retention and the 144 cases without carbon dioxide retention.ResultsCompared with the non-carbon dioxide retention group, the group with carbon dioxide retention had a higher number of hospitalizations in the previous 12 months (p = 0.013), higher modified Medical Research Council (mMRC) dyspnea scores (p = 0.034), lower arterial oxygen pressure (p = 0.018), worse pulmonary function (forced expiratory volume in one second/forced vital capacity [FEV1/FVC; p < 0.001], FEV1%pred [p < 0.001], Z5%pred [p = 0.004], R5%pred [p = 0.008], R5-R20 [p = 0.009], X5 [p = 0.022], and Ax [p = 0.011]), more severe lung damage (such as increased lung volume [p = 0.011], more emphysema range [p = 0.007], and lower mean lung density [p = 0.043]). FEV1 < 1 L (odds ratio [OR] = 4.011, 95% confidence interval [CI]: 2.216–7.262) and emphysema index (EI) > 20% (OR = 1.926, 95% CI: 1.080–3.432) were independently associated with carbon dioxide retention in COPD.ConclusionCompared with the non-carbon dioxide retention group, the group with carbon dioxide retention had different clinical, pulmonary function, and imaging features. FEV1 < 1 L and EI > 20% were independently associated with carbon dioxide retention in AECOPD.Trial registrationChiCTR-OCH-14004904. Registered 25 June 2014.Electronic supplementary materialThe online version of this article (10.1186/s12890-018-0691-8) contains supplementary material, which is available to authorized users.

Different Smoking Statuses on Survival and Emphysema in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

“…A model was established to elucidate the dependence of EI>20% on smoking and other factors. Clinical practice and literature, 9 , 10 , 13 outline the following factors which were included in the univariable logistic regression analysis: smoking (yes), age (>65 years), FEV1% pred (<50%), BMI (<21), PaO 2 (<60%), PaCO 2 (>50%), CAT (>10), mMRC (>2), KCO (<80% and ≥60%, <60%), complications (yes), and acute exacerbation hospitalization in the past 1 year (yes). A multicollinearity analysis was performed to ensure no collinearity among outcomes.…”

“…The routinely administered self-report questionnaires of the COPD Assessment Test (CAT) and Modified Medical Research Council Dyspnea Index (mMRC) were collected from the medical charts. 10 , 13 …”

“…The CT imaging parameters assessed included the percentage of the wall area (%WA), emphysema, mean emphysema density (MED), mean lung density (MLD), lung capacity (LC), and emphysema heterogeneity index (HI) of the whole lung, right lung, and left lung detected by 64-detector CT (SOMATOM Definition AS, Siemens HealthCare, Germany) and analyzed using an in-house system (FACT-Digital Lung) 14 and collected as described previously. 10 , 13 The primary outcome of this study was the 5-year survival rate. Patients were followed up until April 2021.…”

“…The COPDGene study assessed the patients in a multidimensional fashion to enhance the understanding of the complex structural and functional changes in COPD. 9 In previous studies by the authors’ group, 10–13 the parameters mentioned above were combined to uncover the characteristics of the AECOPD population.…”

Albuterol combined with tiotropium bromide to improve the conditions and pulmonary functions of patients with acute exacerbation of chronic obstructive pulmonary disease

“…AECOPD is a phenomenon of serious deterioration as a result of acute onset of COPD in the consequence of severe lung infection. If AECOPD is not carefully and timely treated, it can further develop into pulmonary heart disease and respiratory failure, which seriously affect the quality of life and safety of patients (Adeloye et al 2015;Lipson et al 2018;Wei et al 2018). The key to clinical COPD treatment lies in effectively relieving patients from airway resistance and respiratory muscle fatigue, maintaining clear respiratory tract, and actively improving dyspnea-related syndromes to enhance patient PF.…”