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two groups: those transferred to the ICU or
P10 deceased (G1), and those not transferred to the
ICU (G2).
ALVEOLAR-ARTERIAL OXYGEN
GRADIENT: AN EARLY MARKER Results:
FOR PREDICTING SEVERE We enrolled 214 patients with a mean age of
62.65 ± 9.10 years and a male-to-female sex ratio
PNEUMONIA IN COPD PATIENTS of 2.5. Of the total, 118 patients (55%) required
W. JELASSI1, S. TOUJANI1, K. EUCHI1, S. CHEIKHROUHOU1, Y. ICU transfer, and 21 patients (9.8%) died during
OUAHCHI1, M. MJID1, A. HEDHLI1, B. DHAHRI1 the study period, with non-survivors
predominantly classified as Group E. No
1PULMONOLOGY DEPARTMENT, LA RABTA HOSPITAL, RL 18SP02,
FACULTY OF MEDICINE OF TUNIS, TUNIS EL MANAR UNIVERSITY significant difference was observed in PaO2
- TUNIS (TUNISIA) levels between the two groups. A ROC curve,
for D(A-a)O2 >60 mmHg in detecting severe
Introduction: pneumonia, showed an area under the curve
Several factors, including the degree of airflow (AUC) of 0.886 (95% CI: 0.685−1), while the AUC
obstruction, have been identified as predictive of PaO2/FiO2 < 261 mmHg resulted 0.792 (95% CI:
metrics in chronic obstructive pulmonary 0.504−1). D(A-a)O2 in comparison to PaO2/FiO2
disease (COPD). However, blood gas analyses had a higher sensibility (80.8% vs. 66.7%),
have primarily focused on acute exacerbations. positive predictive value (83% vs. 71.4%),
The alveolar-arterial oxygen gradient (D(A-a)O₂) negative predictive value (94% vs. 91%), and
measures the difference between oxygen similar specificity (95% vs. 95.5%).
concentrations in the alveoli and arterial blood, Conclusion:
accurately indicating ventilatory efficiency. This
study aimed to evaluate the D(A-a)O₂ gradient Our study indicates that the alveolar-arterial
as a predictive marker for severe pneumonia in oxygen gradient (A-a O₂) is more effective than
COPD patients, compared to the PaO₂/FiO₂ the PaO₂/FiO₂ ratio for early identification of
ratio. COPD patients at risk of severe pneumonia,
enabling timely interventions to prevent
Methods: complications.
We conducted a cross-sectional study in a
cohort of consenting patients followed for
confirmed COP with a history of P11
hospitalization for CAP at the pulmonology
Department of La Rabta Hospital, from January DOCOSAPENTAENOIC ACID AND
2022 until August 2023. Disease severity was ITS METABOLITE: POTENTIAL
assessed using spirometry, the improved ABCD BIOMARKERS FOR CHRONIC
assessment tool according to the latest Global
Initiative on Obstructive Lung Disease (GOLD) OBSTRUCTIVE PULMONARY
2023 recommendations, and the modified DISEASE MANAGEMENT
Medical Research Council (mMRC) dyspnea
scale. The Alveolar-Arterial Oxygen Gradient W. JELASSI1, A. HEDHLI1, K. EUCHI1, M. MJID1, Y. OUAHCHI.1,
(A-a O₂) is calculated by subtracting the arterial S. CHEIKHROUHOU1, S. TOUJANI1, B. DHAHRI1
oxygen pressure (PaO₂) from the estimated 1PULMONOLOGY DEPARTMENT, LA RABTA HOSPITAL, RL 18SP02,
alveolar oxygen pressure (PAO₂), using the FACULTY OF MEDICINE OF TUNIS, TUNIS EL MANAR UNIVERSITY
- TUNIS (TUNISIA)
equation: A-a O₂ = (FiO₂ × (Patm - PH₂O) -
PaCO₂/R) - PaO₂. Patients were divided into
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