Aсid-Base and Gas Status of Blood in COVID-19 Patients with “Guiet Hypoxia”
Authors: Оleg V. Voennov, Кonstantin V. Моkrov, Valery I. Zаgrekоv, Sergey А. Аbramov, Danyil S. Chumanov, Olesya N. Gunderchuk
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An observational prospective study was conducted, during which 50 patients of both sexes with severe COVID-19 and moderate manifestations of acute respiratory failure were examined. The study included patients who showed a decrease in transcutaneous saturation of less than 93 %, with a respiratory rate of no more than 25 per minute, who did not have complaints of dyspnea and impaired consciousness, but required, according to temporary clinical recommendations for the treatment of patients with COVID-19, correction of respiratory disorders. We determined the values of transcutaneous saturation using pulse oximetry, studied the acid-base state and gas composition of arterial and venous blood, and also took into account complaints of respiratory disorders, respiratory rate, the presence of forced breathing, heart rate, the "white spot" symptom and blood lactate level. The selected methods of treatment of respiratory disorders, necessary for the correction of acute respiratory failure, and the results of hospitalization were also taken into account. Based on the data obtained, it was concluded that in patients with COVID-19 "silent hypoxia" is associated with the development of moderate compensated arterial hypoxemia without the development of hypercapnia, tissue hypoxia and acidosis. Arterial hypoxemia in patients with "silent hypoxia" is compensated by known compensatory mechanisms – an increase in the delivery and utilization of oxygen to the tissues and an increase in the alkaline reserve. Moderate arterial hypoxemia without tissue hypoxia is corrected by pron-position and oxygen therapy, and does not require conversion to artificial ventilation.