Table · dataset · 2026
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<div> <p>Background</p><p>Respiratory failure is the leading cause of death in amyotrophic lateral sclerosis (ALS).
Description
Early detection of CO<sub>2</sub> retention is crucial for assessing respiratory failure severity and guiding noninvasive positive pressure ventilation (NPPV) management. However, arterial blood gas analysis is invasive and uncomfortable for routine monitoring.</p> <p>Objective</p><p>We investigated whether the serum sodium-chloride difference (Na-Cl value), calculated from routine blood tests, could serve as a screening marker for CO<sub>2</sub> retention in ALS patients.</p> <p>Methods</p><p>This retrospective study included 88 ALS patients with 116 paired samples of arterial blood gas and serum electrolyte data.
We analyzed correlations between Na-Cl value and blood gas parameters (HCO<sub>3</sub><sup>−</sup>, PCO<sub>2</sub>), performed receiver operating characteristic (ROC) analysis for detecting CO<sub>2</sub> retention (PCO<sub>2</sub> ≥ 45 mmHg), and examined relationships with respiratory function (%FVC).</p> <p>Results</p><p>Na-Cl value showed strong correlation with HCO<sub>3</sub><sup>−</sup> (r = 0.78, p < 0.001) and PCO<sub>2</sub> (r = 0.71, p < 0.001).
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Na-Cl ≥ 37 mEq/L demonstrated sensitivity of 85.11% and specificity of 69.57% for detecting PCO<sub>2</sub> ≥ 45 mmHg, with negative predictive value of 87.27% (AUC = 0.842). Na-Cl ≥ 39 mEq/L achieved specificity of 92.75%. Patients with %FVC < 50% had significantly higher Na-Cl, PCO<sub>2</sub>, and HCO<sub>3</sub><sup>−</sup> values.</p> <p>Conclusions</p><p>Serum Na-Cl value serves as a simple, noninvasive screening marker for CO<sub>2</sub> retention in ALS.
Na-Cl ≥ 37 mEq/L warrants blood gas analysis, while Na-Cl ≥ 39 mEq/L provides specificity >90%. This marker can be calculated from routine blood tests without additional cost, making it suitable for frequent monitoring and reducing the risk of missing intervention timing.</p></div>
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- DOI doi.org/10.1371/journal.pone.0358772.s003 ↗
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Catalogue records · 1
- OAI-PMH record api.figshare.com/v2/oai?verb=GetRecord&metadataPrefix=oai_dc&identifier=oai%3Af… ↗
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Provenance · 1 source records, 24 field assertions
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| figshare | oai:figshare.com:article/33938142 | 8 d ago | JSON v1 |
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