GIÁ TRỊ PCO2 ĐO QUA DA VÀ CÁC THÔNG SỐ LÂM SÀNG, KHÍ MÁU ĐỘNG MẠCH TRÊN BỆNH NHÂN ĐỢT CẤP BỆNH PHỔI TẮC NGHẼN MẠN TÍNH

Abstract

Objective: To describe some clinical characteristics, arterial blood gases, and transcutaneous PCO2 (PtcCO2) on patients with acute exacerbation of chronic obstructive pulmonary disease (COPD). Method: A case series of 30 patients diagnosed with COPD exacerbation based on the GOLD 2022 criteria. These patients were admitted to the Center for Critical Care Medicine at Bach Mai Hospital from November 2022 to August 2022. The study aimed to evaluate clinical indicators, arterial blood gas parameters, and PtcCO2 values. Results: Among the 30 eligible patients enrolled in the study, aged between 49 and 93 years (mean 70.3 ± 9.7 years), a total of 88 measurements and comparisons were conducted. The main comorbidities observed were hypertension (26.7%), diabetes (20.0%), and heart failure (13.3%). Based on the severity classification of COPD exacerbations, 83.33% of patients experienced severe exacerbations, while 16.67% had moderate exacerbations. The majority of blood gas samples showed increased PaCO2 (72.7%) and decreased PaO2 (44.3%), with an average PaCO2 value of 55.8 ± 13.3. The average PtcCO2 value was 52.6 ± 13.1 (ranging from 30.2 to 82.0). The mean PtcCO2 values for the invasive mechanical ventilation, non-invasive ventilation/high-flow nasal cannula, and oxygen therapy with goggles/mask groups were 54.2 ± 13.0, 51.7 ± 12.9, and 42.6 ± 10.8, respectively. Conclusions: Most patients with COPD exacerbations admitted to the ICU are elderly with multiple comorbidities and severe exacerbations. Increased PaCO₂ and decreased PaO₂ are common. The group of patients undergoing invasive mechanical ventilation had higher PtcCO₂ results compared to the group of patients using other ventilation methods.