ELECTROLYTE DISTURBANCES IN EXACERBATIONS OF ASTHMA AND COPD

Uğur GÖNLÜGÜR, İnan ERDOĞAN, Levent ÖZDEMİR, İbrahim AKKURT, Ahmet AKER

Abstract

Electrolyte disturbances can occur in the course of obstructive lung diseases. These anomalies can cause airway dysfunction or respiratory muscle weakness. We investigated electrolyte profiles in asthma attacks and chronic obstructive pulmonary disease (COPD) exacerbations in our study. 35 patients with COPD exacerbations with respiratory failure, 27 patients with asthma attack, and 15 control patients with no infectious findings and pulmonary symptoms included the study. Sodium, potassium, chloride, phosphorus, magnesium, total and ionized calcium, arterial blood pH, total protein, albumin levels were measured within the 24 hours after hospitalization. The patients with asthma attack had lower total protein and albumin levels than controls (p<0.01). The patients with COPD had lower pH and magnesium levels but higher ionized calcium levels than asthmatics (p<0.01). There was positive correlation between pH and serum magnesium levels in the entire group (p<0.01). Lower levels of albumin in patients with asthma may be due to higher age, acute phase response or increase of vascular permeability in bronchi and lower levels of magnesium and higher levels of ionized calcium to respiratory acidosis in COPD patients.

Özet

Obstrüktif akci¤er hastal›klar›n›n seyrinde elektrolit dengesizli¤i meydana gelebilmektedir. Bu dengesizlikler havayolu disfonksiyonuna veya solunum kas zay›fl›¤›na neden olabilmektedir. Çal›flmam›zda ast›m ve kronik obstrüktif akci¤er hastal›¤› (KOAH) akut ataklar›nda elektrolit profillerini araflt›rd›k. KOAH akut ata¤› ve solunum yetmezli¤i olan 35 olgu, ast›m ata¤› olan 27 olgu ve pulmoner semptom tan›mlamayan enfeksiyon bulgusu olmayan 15 kontrol olgusu çal›flmaya dahil edildi. Hastaneye yatt›ktan sonraki 24 saat içinde sodyum, potasyum, klor, fosfor, magnezyum, arter kan› pH, total ve iyonize kalsiyum, total protein ve albümin düzeyleri ölçüldü. Ast›m atak olgular›n›n kontrol olgular›ndan daha düflük albümin ve total protein düzeyleri vard› (p<0.01). KOAH’l› olgular ast›ml›lardan daha düflük pH ve magnezyum ancak daha yüksek iyonize kalsiyum düzeylerine sahiptiler (p<0.01). Tüm grupta pH ile serum magnezyum düzeyleri aras›nda pozitif korelasyon vard› (p<0.01). Ast›ml› olgulardaki azalm›fl albumin düzeyi ileri yafla, akut faz yan›t›na veya bronfllardaki artm›fl vasküler permeabiliteye; KOAH‘l› olgulardaki düflük magnezyum, yüksek iyonize kalsiyum düzeyleri ise solunumsal asidoza bağlı olabilir.