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. 2019 Feb;47(2):791-802.
doi: 10.1177/0300060518811560. Epub 2018 Nov 29.

Bronchoalveolar pH and inflammatory biomarkers in patients with acute exacerbation of chronic obstructive pulmonary disease

Emilija Lozo Vukovac  1   2 , Kornelija Miše  1   2 , Ivan Gudelj  1   2 , Irena Perić  1   2 , Darko Duplančić  2   3 , Ivica Vuković  2   3 , Zoran Vučinović  4 , Mislav Lozo  3
Affiliations

Bronchoalveolar pH and inflammatory biomarkers in patients with acute exacerbation of chronic obstructive pulmonary disease

Emilija Lozo Vukovac et al. J Int Med Res. 2019 Feb.

Abstract

Objectives: This study aimed to directly measure pH in the lungs, determine lactate dehydrogenase (LDH), C-reactive protein (CRP), and glucose levels in serum and bronchoalveolar aspirate, and identify bacterial pathogens from bronchoalveolar fluid during acute exacerbation of chronic obstructive pulmonary disease (AECOPD).

Methods: We performed an observational, analytical case-control study from February 2015 to March 2017. We included 84 patients with AECOPD and 42 with stable chronic obstructive pulmonary disease (COPD). All participants underwent detailed medical anamnesis, a clinical examination, chest radiography, spirometry, an arterial blood gas test, bronchoscopy, bacterial culture, and serum/bronchiolar aspirate laboratory testing.

Results: The mean pH of bronchoalveolar fluid was significantly higher in patients with AECOPD than in patients with stable COPD. The mean lung pH value, bronchoalveolar and serum LDH levels, and serum CRP levels in patients with isolated bacteria were higher than those in patients without isolated bacteria in the AECOPD patient group. Lung pH values in patients with AECOPD were significantly correlated with bronchoalveolar LDH and glucose levels.

Conclusions: AECOPD is associated with local cell and tissue injury in the lungs, especially in the presence of bacterial pathogens, which is accompanied by a low systemic inflammatory response.

Keywords: C-reactive protein; Chronic obstructive pulmonary disease; bronchoalveolar aspirate; disease exacerbation; glucose; lactate dehydrogenase.

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Figures

Figure 1.
Figure 1.
A flow diagram of all assessed patients (included and excluded). This figure shows the number of patients assessed for eligibility and number of patients completing the study. Only patients with acute exacerbation of chronic obstructive disease, who had completed the whole study protocol, were included in the present analysis.
Figure 2.
Figure 2.
Relationship between bronchoalveolar lactate dehydrogenase (BA-LDH) and pH at acute exacerbation of chronic obstructive pulmonary disease.
Figure 3.
Figure 3.
Relationship between bronchoalveolar glucose (Ba-Glu) levels and pH at acute exacerbation of chronic obstructive pulmonary disease.
See this image and copyright information in PMC

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