Spectrum of arterial blood gas alterations in COVID-19 patients admitted in ICU with multiorgan involvement

ABSTRACT

AIM: To assess the arterial blood gas alterations in COVID-19 patients admitted in ICU with multi-organ involvement. METHODS: Systematic research of articles assessing the arterial blood gas alterations was performed with NCBI as the search engine during the year 2020-2021. Baseline arterial blood gas data were taken. A pH of < 7.35 was categorized as acidaemia & pH of >7.45 was categorized as alkalemia. Patients with multiple organ involvement such as liver, kidney, muscle were considered in this study. All types of acid - base disorders were seen in these review of journals. RESULTS: ABG analysis revealed low arterial partial pressure of oxygen, altered pH, pCO2 & bicarbonate levels. Most of the patients had low oxygen saturation(<90%) leading to acute respiratory distress syndrome. 8 articles revealed arterial blood gas alterations pertaining to acid-base disorders which includes original studies & a case report. Respiratory alkalosis (3 studies), metabolic acidosis (3 studies) followed by metabolic alkalosis (2 studies). Majority of patients had comorbid conditions like diabetes, hypertension, cardiovascular disease, cerebrovascular disease. CONCLUSION: Most common acid - base disorder that occurred in patients were respiratory alkalosis with compensatory metabolic acidosis. A higher proportion of females were affected with respiratory alkalosis. Equal prevalence of metabolic alkalosis condition was also noted in COVID-19 patients. Primary alteration in COVID patients resulting in death was metabolic acidosis which could be due to inadequate respiratory compensation due to primary involvement of lungs by COVID-19 infection, increased lactate levels due to hypoxia. Hence it's advisable to screen for acid-base disorders in all COVID-19 patients irrespective of severity of disease.