Publikation

Temporal Changes in the Oxyhemoglobin Dissociation Curve of Critically Ill COVID-19 Patients

Wissenschaftlicher Artikel/Review - 31.01.2022

Bereiche
DOI
Kontakt

Zitation
Ceruti S, Garzoni C, Spagnoletti M, Greco P, Marzano M, Bona G, Biggiogero M, Glotta A, Minotti B, Bendjelid K. Temporal Changes in the Oxyhemoglobin Dissociation Curve of Critically Ill COVID-19 Patients. Journal of Clinical Medicine 2022; 11:788.
Art
Wissenschaftlicher Artikel/Review (Englisch)
Zeitschrift
Journal of Clinical Medicine 2022; 11
Veröffentlichungsdatum
31.01.2022
Seiten
788
Verlag
MDPI
Kurzbeschreibung/Zielsetzung

Critical COVID-19 is a life-threatening disease characterized by severe hypoxemia with complex pathophysiological mechanisms that are not yet completely understood. A pathological shift in the oxyhemoglobin curve (ODC) was previously described through the analysis of p50, intended as the oxygen tension at which hemoglobin is saturated by oxygen at 50%. The aim of this study was to analyze Hb-O2 affinity features over time in a cohort of critically ill COVID-19 patients, through the analysis of ODC p50 behavior. A retrospective analysis was performed; through multiple arterial blood gas (ABG) analyses, each p50 was calculated and normalized according to PaCO2, pH and temperature; patients’ p50 evolution over time was reported, comparing the first 3 days (early p50s) with the last 3 days (late p50s) of ICU stay. A total of 3514 ABG analyses of 32 consecutive patients were analyzed. The majority of patients presented a left shift over time (p = 0.03). A difference between early p50s and late p50s was found (20.63 ± 2.1 vs. 18.68 ± 3.3 mmHg, p = 0.03); median p50 of deceased patients showed more right shifts than those of alive patients (24.1 vs. 18.45 mmHg, p = 0.01). One-way ANOVA revealed a p50 variance greater in the early p50s (σ2 = 8.6) than in the late p50s (σ2 = 3.84), associated with a reduction over time (p < 0.001). Comparing the Hb-O2 affinity in critically ill COVID-19 patients between ICU admission and ICU discharge, a temporal shift in the ODC was observed.