During CPAP treatment, we found these patients to http://www.selleckchem.com/products/CHIR-258.html have a quicker increase of pH values in comparison with the other acidotic patients, in light of the double action of CPAP on both respiratory mechanics and hemodynamics.In view of its retrospective design, a weakness of our study could be a deficiency in accurately collecting some history and clinical information. To our knowledge, the present study is the first to evaluate the impact of different acidosis patterns on admission in ACPE patients treated with CPAP. This study is strengthened by a large sample size of consecutive ACPE patients. Moreover, our findings are representative of an unselected population, and our conclusions can thus be easily generalized.ConclusionsNeither acidemia nor the type of acidosis on admission should be considered a risk factor for adverse outcomes in ACPE patients treated with CPAP.

Furthermore, we suggest that nonacidotic patients should be included in future clinical trials, being at least as severe as the acidotic population.Key messages? Acidemia on admission is not a risk factor for adverse outcomes in patients with ACPE treated with CPAP.? The type of acidosis on admission – respiratory, metabolic or mixed – does not impact clinical outcomes of ACPE patients treated with CPAP.AbbreviationsACPE: acute cardiogenic pulmonary edema; CPAP: continuous positive airways pressure; ETI: endotracheal intubation; HCO3-: bicarbonates; NIV: non-invasive ventilation; PaCO2: partial pressure of carbon dioxide in arterial blood; PaO2/FiO2: partial pressure of oxygen in arterial blood/inspired oxygen fraction; PEEP: positive end-expiratory pressure.

Competing interestsThe authors declare that they have no competing interests.Authors’ contributionsSA contributed to the conception and design of the study, as well as the acquisition, analysis and interpretation of data; he was involved in drafting the manuscript and revising it critically for important intellectual content. RC and AMB contributed to the conception and design of the study, the analysis and interpretation of data; they were involved in revising the manuscript. AAB contributed to the conception and design, analysis and interpretation of data; he was involved in revising the manuscript. FP, TM and VDR contributed to the acquisition, analysis and interpretation of the data; they were involved in revising the manuscript critically.

VM revised the manuscript. All authors read and approved the final manuscript.Supplementary MaterialAdditional file 1:The acidotic population. A Word table presenting demographics, comorbidities, severity of the disease, clinical and laboratory findings on admission and before CPAP treatment of the acidotic population, according AV-951 to the type of acidemia on admission.Click here for file(99K, DOC)NotesSee related commentary by Schlosshan and Elliot, http://ccforum.