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

Abstract 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 conseque...

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Main Authors: Nikolai Ravn Aarskog, Hanna Othilie Lindvig Bjørsrud, Aleksander Rygh Holten, Leiv Otto Watne, Bjørn Erik Neerland, Morten Rostrup
Format: Article
Language:English
Published: Nature Portfolio 2025-08-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-13016-0
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author Nikolai Ravn Aarskog
Hanna Othilie Lindvig Bjørsrud
Aleksander Rygh Holten
Leiv Otto Watne
Bjørn Erik Neerland
Morten Rostrup
author_facet Nikolai Ravn Aarskog
Hanna Othilie Lindvig Bjørsrud
Aleksander Rygh Holten
Leiv Otto Watne
Bjørn Erik Neerland
Morten Rostrup
author_sort Nikolai Ravn Aarskog
collection DOAJ
description Abstract 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.
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issn 2045-2322
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series Scientific Reports
spelling doaj-art-19f604ecae2b48869ae209605ce647162025-08-20T03:05:29ZengNature PortfolioScientific Reports2045-23222025-08-0115111010.1038/s41598-025-13016-0Ventilatory response and delirium risk in hospitalised patients with acute hypoxia due to COVID-19Nikolai Ravn Aarskog0Hanna Othilie Lindvig Bjørsrud1Aleksander Rygh Holten2Leiv Otto Watne3Bjørn Erik Neerland4Morten Rostrup5Institute of Clinical Medicine, University of OsloInstitute of Clinical Medicine, University of OsloInstitute of Clinical Medicine, University of OsloInstitute of Clinical Medicine, University of OsloOslo Delirium Research Group, Department of Geriatric Medicine, Division of Medicine, Oslo University HospitalDepartment of Acute Medicine, Division of Medicine, Oslo University HospitalAbstract 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.https://doi.org/10.1038/s41598-025-13016-0Cerebral vasoconstrictionCOVID-19DeliriumHypocapniaHypoxiaHypoxic ventilatory response
spellingShingle Nikolai Ravn Aarskog
Hanna Othilie Lindvig Bjørsrud
Aleksander Rygh Holten
Leiv Otto Watne
Bjørn Erik Neerland
Morten Rostrup
Ventilatory response and delirium risk in hospitalised patients with acute hypoxia due to COVID-19
Scientific Reports
Cerebral vasoconstriction
COVID-19
Delirium
Hypocapnia
Hypoxia
Hypoxic ventilatory response
title Ventilatory response and delirium risk in hospitalised patients with acute hypoxia due to COVID-19
title_full Ventilatory response and delirium risk in hospitalised patients with acute hypoxia due to COVID-19
title_fullStr Ventilatory response and delirium risk in hospitalised patients with acute hypoxia due to COVID-19
title_full_unstemmed Ventilatory response and delirium risk in hospitalised patients with acute hypoxia due to COVID-19
title_short Ventilatory response and delirium risk in hospitalised patients with acute hypoxia due to COVID-19
title_sort ventilatory response and delirium risk in hospitalised patients with acute hypoxia due to covid 19
topic Cerebral vasoconstriction
COVID-19
Delirium
Hypocapnia
Hypoxia
Hypoxic ventilatory response
url https://doi.org/10.1038/s41598-025-13016-0
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