ANAEMIA IN CHRONIC RESPIRATORY FAILURE

Florian Kollert (1) , Carolin Müller (2) , Andrea Tippelt (2) , Rudolf Jorres (3) , Dominic Heidinger (2) , Corina Probst (4) , Michael Pfeifer (2, 5) , Stephan Budweiser (2, 6)

1 Rheumatology and Clinical Immunology
2 Center for Pneumology
3 Institute and Outpatient Clinic for Occupational and Environmental Medicine
4 Department of Pneumology
5 Department of Internal Medicine II, Division of Respirology, University of Regensburg, Regensburg, Germany
6 Department of Internal Medicine III, Division of Respirology

Background: In patients with severe chronic obstructive pulmonary disease (COPD), anaemia is common and associated with impaired long-term survival and quality of life. Whether anaemia is also prevalent in patients with other severe, non-inflammatory respiratory diseases has not yet been systematically tested. Methods: In 595 patients with obstructive (OD, 54.8%) or restrictive disease (RD, 45.2%) and chronic respiratory failure (CRF), anthropometric data, laboratory parameters, lung function, blood gases and co-morbidities were assessed prior to initiation of home mechanical ventilation. Patients were classified as anaemic based on haemoglobin (Hb) levels (Hb <12/13g/dl, female/male). Patients with known causes for anaemia were excluded. Results: In patients with CRF the prevalence of anaemia was 13.3% and not different between RD (11.5%) and OD (14.7%) (p=0.276). A sex-related difference occurred only in OD (7.9% (f) versus 17.3% (m); p=0.035). Patients with OD and anaemia presented with higher age (p=0.003), pH (p=0.014) and arterial oxygen pressure (PaO2) (p=0.012), lower body-mass index (BMI) (p=0.011) and total protein (p=0.012), and higher rates of coronary heart disease (p=0.01), cardiac arrhythmia (p=0.014) and diabetes mellitus (p=0.003) in comparison to non-anaemic patients. In patients with RD anaemia was associated with higher age, (p=0.008), pH (p=0.011) and lower leucocytes numbers (p=0.006). Conclusions: Anaemia is frequent not only in COPD but also in other severe respiratory diseases combined with CRF. It was associated with advanced age, several co-morbidities, impaired nutritional state and elevations of pH and PaO2, probably due to hyperventilation. Its prognostic impact has to be elucidated in future studies.

Mots clés: Medicine

Florian Kollert, Carolin Müller, Andrea Tippelt, Rudolf Jorres, Dominic Heidinger, et al.. ANAEMIA IN CHRONIC RESPIRATORY FAILURE. International Journal of Clinical Practice, 2011, 65 (4), pp.479. ⟨10.1111/j.1742-1241.2011.02631.x⟩. ⟨hal-00623801⟩