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Acid-base disturbances in cardiogenic pulmonary edema
R O'Donovan1, J A McGowan, L Lupinacci
1Department of Medicine, University of Pittsburgh School of Medicine, Pa.
Nephron
|January 1, 1991
Summary
In cardiogenic pulmonary edema (CPE), isolated respiratory alkalosis is the most frequent acid-base disturbance. However, acid-base abnormalities did not correlate with disease severity, morbidity, or mortality in this study.
Area of Science:
- Cardiology
- Pulmonology
- Critical Care Medicine
Background:
- Cardiogenic pulmonary edema (CPE) is a critical condition often associated with acid-base disturbances.
- Understanding the relationship between acid-base balance and CPE severity is crucial for patient management.
Purpose of the Study:
- To investigate the prevalence of acid-base abnormalities in uncomplicated CPE.
- To determine the correlation between acid-base disturbances, chest roentgenogram (CXR) severity, morbidity, and mortality in CPE patients.
Main Methods:
- Retrospective analysis of 81 consecutive patients with uncomplicated CPE.
- Grading of CXR severity and classification of acid-base abnormalities (single or mixed).
- Comparison of demographic data, morbidity, and mortality across different acid-base groups.
Main Results:
- Isolated respiratory alkalosis was the most common acid-base disturbance (41%), followed by metabolic acidosis (22%).
- Twenty-three percent of patients had no acid-base disturbances.
- No significant correlation was found between CXR scores and acid-base parameters, morbidity, or mortality.
- Higher mortality was associated with age >70, pH <7.4, and acute myocardial infarction.
Conclusions:
- Isolated respiratory alkalosis is the most common acid-base abnormality in uncomplicated CPE.
- Acid-base status does not reliably predict CPE severity, morbidity, or mortality.
- Clinical factors like age and acute myocardial infarction are more significant predictors of mortality.