Page 58 - Livre électronique du congrès national de pneumologie 2023

40 male patients, with confirmed COPD and in stable
condition. This group was matched to the patient P71 ASSESSING
group. Patients with COPD-associated respiratory OXYHEMOGLOBIN IN CHRONIC
disease and receiving immunosuppressive treatment OBSTRUCTIVE PULMONARY DISEASE
were excluded. Patients were interviewed and PATIENTS ADMITTED FOR SEVERE
examined. The severity of the disease was assessed
using the ABCD assessment tool of the Global Initiative COMMUNITY-ACQUIRED
for Chronic Obstructive Lung Disease 2022 (GOLD). PNEUMONIA
Blood samples including prostaglandins (D2, E2, F2alpha
and 6-keto-prostaglandin 1 alpha), C-reactive protein W. JELASSI, S. TOUJANI, K. EUCHI, N.H. KHEZAMI, N.
(CRP) levels as well as a forced airway measurement HAMMOUDA, S. CHEIKHROUHOU, Y. OUAHCHI, M. MJID,
were performed. HEDHLI. A, B. DHAHRI
PNEUMOLOGY DEPARTMENT, LA RABTA HOSPITAL, LR18SP02, TUNIS
Results : FACULTY OF MEDICINE, TUNIS EL MANAR UNIVERSITY, TUNIS, TUNISIA

The mean age was 64 ±8 years in patients versus 59±7 Introduction :
years in controls. COPD was classified as stage 3 in 17% Various variables, such as the Body Mass Index (BMI)
of cases and stage 4 in 17% of cases. The distribution of and the degree of airflow obstruction have been
patients according to the ABCD assessment tool was : shown to be a predictive metric in chronic obstructive
GOLD A in 5%, GOLD B in 55%, GOLD C in 20% and GOLD pulmonary disease (COPD). The use of blood gas
D in 20%. The analysis of prostaglandins showed a analyses has been largely restricted to the acute
significantly higher levels of PGD2 (p< 10-3), PGE2 (p< 10- exacerbations of the disease. Recent studies have
3), PGF2a (p< 10-3) and 6-Keto-prostalgandin 1-alpha (6-K- demonstrated that oxygenated hemoglobin
PG-1a) in the COPD group. PGE2 had the highest (OxyHem) is a useful prognostic predictor in acute
significant diagnostic value on the ROC curve analysis exacerbations of COPD.
(AUC=0,826, P< 10-3). The risk of COPD was 13 times
higher for PGD2, 31 times higher for PGE2, about 3 times The objective of our study was to assess the predictive
higher for PGF2a, and 7 times higher for 6-Keto-PG1a. prognostic value of OxyHem in patients admitted for
severe community acquired pneumonia (CAP) in this
PGF2a, PGD2 and CRP plasma levels had a negative category of patients.
correlation with peripheral oxygen saturation (r=-0,360,
p=0,023; r=-0,333, p=0,036; and r=-0,568, P<10-3 Methods
respectively).
We conducted a cross-sectional study in a cohort of
The analysis of these biomarkers according to groups consenting patients followed for confirmed COPD with
and stages of COPD showed a significantly negative a history of hospitalisation for CAP at a pulmonology
correlation between PGD2 and Forced expiratory Department, from January 2022 until August 2023.
volume in one second (FEV1) (r=-0,374, p=0,017). Disease severity was assessed using spirometry, the
improved ABCD assessment tool according to the
No correlation was found between prostaglandins and latest Global Initiative on Obstructive Lung Disease
the number or severity of acute exacerbations of COPD. (GOLD) 2023 recommendations, and the modified
Conclusions: Medical Research Council (mMRC) dyspnea scale. We
calculated OxyHem (hemoglobin concentration [Hb] ×
This study offers useful and critical data that contribute fractional SpO2, g/dL) from oxygen saturation
to a better understanding of the etiopathogenic measured by pulse oximetry and hemoglobin
mechanisms involved in COPD. assessed at admission. Patients were divided in two
groups: Group 1 (G1) represented patients who either

were transferred to the intensive care unit (ICU) or who
died ; Group 2 (G2) : patients who were not transferred
to the ICU.

Results

We included 104 patients. The mean age was 0.63±11.14
years with a sex ratio of 4.2. Active smoking was noted
in 63 (60.57%) patients. Overall, 59 (56.7%) were
transferred to the ICU and 11 patients (10.5%) died. Non-

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