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<p>Mountaineers with a high ventilatory response to hypoxia experience greater cognitive impairment at high altitude, possibly because hyperventilation causes hypocapnia, cerebral vasoconstriction and ultimately cerebral ischaemia. We hypothesised that a high ventilatory response, and consequently a lower arterial partial pressure of carbon dioxide (PaCO<sub>2</sub>), could increase the risk of delirium in hospitalised patients with acute hypoxia. To test our hypothesis, we conducted a cohort study in which PaCO<sub>2</sub> and arterial oxygen saturation were measured upon hospital admission in 126 patients with COVID-19. After adjusting for oxygen saturation, we found that a lower PaCO<sub>2</sub> was associated with a higher risk of delirium during hospital admission (risk ratio 1.67 [95% confidence interval 1.09–2.54] per 1 kilopascal reduction, <i>P</i> = 0.017). The association remained statistically significant after adjusting for other well-established risk factors for delirium. This finding supports our hypothesis that a high hypoxic ventilatory response increases the risk of delirium in patients with acute hypoxia.</p>

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Ventilatory response and delirium risk in hospitalised patients with acute hypoxia due to COVID-19

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年8月3日

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  • Nikolai Ravn Aarskog,
  • Hanna Othilie Lindvig Bjørsrud,
  • Aleksander Rygh Holten,
  • Leiv Otto Watne,
  • Bjørn Erik Neerland,
  • Morten Rostrup

摘要

Mountaineers with a high ventilatory response to hypoxia experience greater cognitive impairment at high altitude, possibly because hyperventilation causes hypocapnia, cerebral vasoconstriction and ultimately cerebral ischaemia. We hypothesised that a high ventilatory response, and consequently a lower arterial partial pressure of carbon dioxide (PaCO2), could increase the risk of delirium in hospitalised patients with acute hypoxia. To test our hypothesis, we conducted a cohort study in which PaCO2 and arterial oxygen saturation were measured upon hospital admission in 126 patients with COVID-19. After adjusting for oxygen saturation, we found that a lower PaCO2 was associated with a higher risk of delirium during hospital admission (risk ratio 1.67 [95% confidence interval 1.09–2.54] per 1 kilopascal reduction, P = 0.017). The association remained statistically significant after adjusting for other well-established risk factors for delirium. This finding supports our hypothesis that a high hypoxic ventilatory response increases the risk of delirium in patients with acute hypoxia.