ArticleBMJ open respiratory research2025
Bicarbonate from arterial blood gas analysis as predictor of sleep-related hypoventilation: a diagnostic accuracy study.
Article in BMJ open respiratory research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundBicarbonate above the upper limit of normal is used as an indicator of sleep-related hypoventilation in patients with diseases frequently associated with hypoventilation, such as obesity or neuromuscular diseases. RESEARCH QUESTION: The aim was to evaluate the diagnostic accuracy of bicarbonate from daytime arterial blood gas analysis for sleep-related hypoventilation measured via transcutaneous nocturnal capnometry.
methodsIn a diagnostic accuracy study, the sensitivity and specificity of bicarbonate concentration for detecting nocturnal hypoventilation were tested using a receiver operating curve (ROC) and logistic regression analysis in patients undergoing both an in-laboratory sleep study with transcutaneous capnometry and daytime arterial blood gas analysis.
resultsIn 510 patients (mean±SD age 52±15 years, BMI 34±10 kg/m
conclusionsThe sensitivity of elevated bicarbonate from awake arterial blood gas analysis using common cut-off values such as 27 mmol/L is only moderate, and bicarbonate as an integral part of the assessment of sleep hypoventilation (likelihood ratio) must be interpreted in the context of other assessments. A normal bicarbonate does not rule out sleep hypoventilation.
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