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    Electrolyte Imbalance and Its Prognostic Impact on All-Cause Mortality in ICU Patients with Respiratory Failure
    (Mdpi, 2025) Mentes, Oral; Celik, Deniz; Yildiz, Murat; Kahraman, Abdullah; Cirik, Mustafa Ozgur; Doganay, Guler Eraslan; Ensarioglu, Kerem
    Background and Objectives: Chronic obstructive pulmonary disease (COPD) and acute respiratory failure are critical clinical conditions associated with high mortality rates in intensive care units (ICUs). Electrolyte imbalances are significant variables that may influence all-cause ICU mortality in this patient group. In this retrospective study, we aimed to investigate the relationships between the serum levels of sodium (Na+), chloride (Cl-), potassium (K+), calcium (Ca-2(+)), and magnesium (Mg-2(+)) and all-cause ICU mortality in patients admitted with respiratory failure. Additionally, we conducted a detailed mortality analysis on the basis of sodium quartiles and pathological absolute sodium thresholds to reveal their associations with ICU mortality from all causes. Materials and Methods: A total of 1109 patients were analyzed between January 2022 and January 2024. The electrolyte levels measured at ICU admission, demographic data, APACHE II and SOFA scores, arterial blood gas results, BUN and creatinine levels, need for noninvasive mechanical ventilation, length of ICU stay, and survival outcomes were assessed. Statistical analyses were performed via Kaplan-Meier survival analysis and the Cox regression method. Results: Our findings revealed that patients with low potassium and calcium levels had significantly higher mortality rates (p < 0.05). When sodium levels were divided into quartiles, mortality risk markedly increased in both the lowest (Q1) and highest (Q4) quartiles. Cox regression analysis revealed that the mortality risk in hyponatremic patients was 2.2 times greater than that in normonatremic patients (p = 0.005). In the hyponatremic group, the increased mortality risk was statistically borderline significant (p = 0.06). In the logistic regression analysis conducted to evaluate ICU mortality, which included all electrolyte levels and clinical scoring systems, higher APACHE II and SOFA scores were identified as significant risk factors for ICU mortality. Conversely, the presence of COPD was found to be relatively protective compared with other underlying causes of respiratory failure in terms of mortality. Conclusions: Electrolyte imbalances are important predictors of mortality in patients with respiratory failure. Sodium levels exhibit a U-shaped relationship with mortality, with hyponatremia emerging as a prominent risk factor. Careful assessment of electrolyte imbalances is crucial in the clinical management of these patients.
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    The importance of uric acid levels in geriatric patients with respiratory failure under noninvasive mechanical ventilation in the respiratory intensive care unit
    (Bmc, 2025) Yildiz, Murat; Celik, Deniz; Ozdemir, Tarkan; Doganay, Guler Eraslan; Doganci, Melek; Cirik, Mustafa Ozgur; Ari, Maside
    Introduction The respiratory system is critical for gas exchange, with respiratory failure resulting in insufficient oxygen and inadequate removal of carbon dioxide. Serum uric acid (SUA), a byproduct of purine metabolism, rises during hypoxemic conditions and has potential as a prognostic marker in respiratory failure. This study aimed to explore the relationship between SUA levels, mortality, duration of hospital stay, and ICU scores (APACHE II, and SOFA) in geriatric patients receiving non-invasive mechanical ventilation (NIV). Materials and methods We conducted a retrospective analysis of 1109 patients with respiratory failure admitted to the Respiratory Intensive Care Unit (RICU) from 2020 to 2022. We excluded minor patients (under 18 years old), patients with incomplete records, known gout, and dialysis-dependent or SRRT required renal failure. We collected demographics, comorbidities, laboratory findings, APACHE II, and SOFA scores. Patients were divided into two age groups (>= 65 and < 65). Statistical analysis, including chi-square, regression, and correlation tests, was performed to evaluate the association between SUA and clinical outcomes. Results Patients aged >= 65 had significantly higher SUA, creatinine, and BUN levels, as well as longer hospital stays and higher APACHE II and SOFA scores. Elevated SUA levels correlated with increased mortality and NIV requirements in the elderly. Regression analysis confirmed SUA as a predictor of NIV need. Discussion SUA levels are positively associated with worse outcomes in elderly patients with respiratory failure. This study supports previous research findings that hyperuricemia correlates with increased ICU admissions and mortality in respiratory conditions, particularly in older adults who need a noninvasive ventilation (NIV). Conclusion Elevated SUA levels are a valuable prognostic marker for predicting NIV needs and poor outcomes in geriatric patients with respiratory failure. Regular monitoring of SUA could enhance clinical management and improve prognosis in this population.