Predictors of persistent hypercapnia after an hypercapnic AECOPD

Abstract

<b>Introduction:</b> After an episode of hypercapnic AECOPD some patients show reversible, prolonged or persistent hypercapnic respiratory failure. To predict the development of persistent hypercapnia would be helpful to identify patients at high risk. <b>Methods:</b> We collected data retrospectively from COPD patients with an acute hypercapnic exacerbation, treated as inpatients at the University Hospital of Leipzig between August 2010 and March 2018. According to first available blood gases, our sample of 82 follow-up patients was divided into patients with persistent hypercapnia (PHG) or patients with reversible hypercapnia (RHG). Demographic and functional data at different time points were compared. <b>Results:</b> We found 51% of patients with acute hypercapnic AECOPD developing normocapnia after few weeks. Higher disease severity and lower forced vital capacity were more present in patients with persistent hypercapnia. Patients with development of reversibility in terms of hypercapnia had lower pCO2, HCO3, BE and higher pH before the event, at discharge and at follow-up. The binary logistic regression model revealed GOLD D and higher pCO2 at discharge as predicting factors to develop a persistent hypercapnia. <b>Discussion:</b> There exist a panel of predictors of persistent hypercapnia. These patients should be monitored careful after an hypercapnic AECOPD.