Mentes Oral, Celik Deniz, Yildiz Murat, Ensarioglu Kerem, Cirik Mustafa Ozgur, Peker Tulay Tuncer, Canbay Fatma, Doganay Guler Eraslan, Kahraman Abdullah
Department of Intensive Care, Gulhane Training and Research Hospital, 06010 Ankara, Turkey.
Department of Pulmonary Medicine, Faculty of Medicine, Alanya Alaaddin Keykubat University, 07425 Antalya, Turkey.
Medicina (Kaunas). 2025 Apr 11;61(4):705. doi: 10.3390/medicina61040705.
: Chronic obstructive pulmonary disease (COPD) is a notable cause of morbidity and mortality worldwide and can become complicated by Type 2 respiratory failure. This study aimed to analyze the cardiological and metabolic comorbidities of patients admitted to the intensive care unit (ICU) due to COPD-related Type 2 respiratory failure and evaluate their effects on clinical outcomes. : A retrospective analysis was conducted on 258 patients admitted to the secondary-level pulmonary disease intensive care unit between January 2022 and January 2024. Patients' demographic data, cardiological and metabolic comorbidities, laboratory parameters, and ICU-related variables were evaluated using statistical analysis methods. : The most common comorbidities were hypertension (57.0%), congestive heart failure (48.1%), diabetes mellitus (31.4%), and obesity (37.6%). Female patients had significantly higher rates of hypothyroidism, hypertension, obesity, and congestive heart failure compared to males. Patients diagnosed with chronic kidney disease (CKD) had markedly higher cardiothoracic ratios and proBNP levels. ICU length of stay was considerably longer in patients with acute kidney injury (AKI) and coronary artery disease (CAD). Cardiomegaly and obstructive sleep apnea syndrome (OSAS) were more frequently observed in obese patients. Additionally, in COPD patients, a body mass index (BMI) threshold of 25.5 was determined as a cutoff value for radiological cardiomegaly findings with a sensitivity of 69.9% and a specificity of 59.5%. Elevated pCO and bicarbonate levels in patients receiving long-term oxygen therapy (LTOT) were associated with advanced-stage COPD. : Metabolic and cardiological comorbidities notably impact the clinical prognosis and ICU management of patients diagnosed with COPD and Type 2 respiratory failure. This study, which aims to provide a snapshot of the comorbidities in patients requiring ICU admission due to COPD exacerbation-related Type 2 respiratory failure but without a fatal course, seeks to highlight the key areas where preventive and protective healthcare services should be focused in this patient group. Special attention should be given to monitoring female and obese patients. Future studies should explore how individualized and preventive follow-ups and treatment approaches can improve patient outcomes, with a particular emphasis on these identified areas.
慢性阻塞性肺疾病(COPD)是全球发病率和死亡率的重要原因,可并发Ⅱ型呼吸衰竭。本研究旨在分析因COPD相关Ⅱ型呼吸衰竭入住重症监护病房(ICU)患者的心脏和代谢合并症,并评估其对临床结局的影响。
对2022年1月至2024年1月期间入住二级肺病重症监护病房的258例患者进行回顾性分析。使用统计分析方法评估患者的人口统计学数据、心脏和代谢合并症、实验室参数以及与ICU相关的变量。
最常见的合并症为高血压(57.0%)、充血性心力衰竭(48.1%)、糖尿病(31.4%)和肥胖(37.6%)。与男性相比,女性患者甲状腺功能减退、高血压、肥胖和充血性心力衰竭的发生率显著更高。诊断为慢性肾脏病(CKD)的患者心胸比率和脑钠肽前体(proBNP)水平明显更高。急性肾损伤(AKI)和冠状动脉疾病(CAD)患者的ICU住院时间明显更长。肥胖患者中心脏肥大和阻塞性睡眠呼吸暂停综合征(OSAS)更为常见。此外,在COPD患者中,体重指数(BMI)阈值25.5被确定为放射学心脏肥大的截断值,敏感性为69.9%,特异性为59.5%。接受长期氧疗(LTOT)患者的pCO和碳酸氢盐水平升高与晚期COPD相关。
代谢和心脏合并症显著影响诊断为COPD和Ⅱ型呼吸衰竭患者的临床预后和ICU管理。本研究旨在提供因COPD加重相关Ⅱ型呼吸衰竭入住ICU但无致命病程患者合并症的概况,旨在突出该患者群体预防和保护性医疗服务应重点关注的关键领域。应特别关注女性和肥胖患者。未来的研究应探索个体化和预防性随访及治疗方法如何改善患者结局,尤其应重点关注这些已确定的领域。