Arterial blood gas recovery time, rates and factors affecting recovery of patients with COPD acute attack

Objective: Chronic Obstructive Pulmonary Disease (COPD); it is an important cause of mortality and morbidity, which is increasing in frequency in society and is accompanied by exacerbations. Patients in the exacerbation period may experience acute respiratory failure according to the severity of the flare-up and the stage of the disease. Arterial blood gas analysis has an important role in clinical evaluation of patients with acute respiratory failure. The aim of our single-center prospective study is to investigate the frequency of arterial blood gas abnormalities seen in patients hospitalized with COPD acute attack and the factors affecting the rate, time and recovery of these disorders. In addition, since COPD is a chronic inflammatory disease, we aimed to compare IL-6, TNF-alpha and MMP12 levels in patients whose blood gases improved and did not improve during the stable period. Material and method: 50 patients admitted to Çukurova University Medical Faculty Balcalı Hospital Chest Diseases clinic with COPD acute attack were included in the study. Arterial blood gas samples were taken from all patients after hospitalization, discharge day, after discharge between 2-4 weeks and 6-8 weeks. In addition, blood samples were taken for IL-6, TNF-alpha and MMP12 levels during the recovery period between 6-8 weeks. Demographic data of patients, laboratory tests, 1-year emergency admission, ward and intensive care hospitalization numbers were recorded. Results: When the factors affecting the improvement of arterial blood gas findings were examined, it was determined that the improvement was independent with age, gender, BMI, SFT findings, C-reactive protein, pneumonia presence, GOLD staging, Charlson comorbidity index, MMRC score, CAT score, hospitalization time, antibiotic use time, steroid dose and duration of use. In addition, levels of inflammation markers (IL-6, TNF-α and MMP12) were similar among those with and without stabilization in week 6 (p>0.05). Conclusion: Similar clinical and laboratory courses were observed in patients presenting with COPD attacks, patients with and without improvement according to arterial blood gas PaO2. Inflammation markers (IL-6, TNF-α and MMP12) were not intended to be used as prognosis markers after COPD acute attack. Key words: Arter Blood gas, COPD, Acute Attack, Prognosis