Preliminary results and further research
In this descriptive study, we did not analyze the subgroups
derived from the combinations of mixed acid-base disorders and
hydro-electrolyte disturbances because the number of patients was
not sufficient to guarantee a significant statistical power for this
purpose
Probably the descriptive design of the study does not allow us to
obtain definitive conclusions, but we strongly believe to have
investigate a field not yet explored, eventually stimulating further
prospective multicentric studies in order to completely clarify this
topic, which recurs frequently in clinical practice.
Our preliminary results suggest, in fact, that in the clinical
respiratory care researchers should address the following questions:
a) whether lactate clearance is useful during acute
respiratory failure to identify patients at high risk of negative
outcomes and, potentially, to increase the intensity of the
therapeutic approach; b) whether lactate clearance is predictive
of positive outcome and could confirm to physicians that the
current therapeutic approach is appropriate; and c) how both the
metabolic components of mixed acid-base disorders and the
hydroelectrolyte balance alterations may worsen the hypercapnic
respiratory failure caused by the COPD exacerbation and may
affect its resolution through standard medical therapy, either alone
or combined with NIV.