The final outcome depends on various factors, such as the patient��s overall health status and concomitant comorbidities, the baseline lung function, and the disease severity as judged by the need for assisted ventilation and the degree of acidosis. Our observations provide evidence that mixed acid-base and lactate disorders in patients with hypercapnic respiratory failure due to COPD exacerbation lead to the need for and longer duration of NIV. More data should be provided to evaluate this association with combined mixed acid-base and hydroelectrolyte disorders. We observed that metabolic alkalosis with hyponatremia and/ or hypochloremia aggravated the respiratory Publications Using Abomle Cycloheximide acidosis due to the COPD exacerbation. Mixed respiratory acidosis�Cmetabolic alkalosis patients were more likely to use NIV and were subjected to longer periods of ventilation compared to those with pure respiratory acidosis. The requirement for and duration of NIV was associated with low serum sodium and chloride, common findings in diuretic-induced metabolic alkalosis. The clinical parameters and ABG analysis indicated more severe SCH527123 Abmole Neutrophil migration and inflammation in chronic obstructive pulmonary disease ventilatory impairment in the patients with mixed respiratory acidosis�C metabolic alkalosis than in those with pure respiratory acidosis, with the exception of those with an elevated pH due to a simultaneous alkalinizing processes. In patients with hypercapnic respiratory failure due to COPD exacerbation, the presence of a sufficient metabolic compensation and adequate renal function significantly decreases mortality. In our study, the bicarbonate increase overcame the expected renal compensatory response, reflecting a mixed acid-base disorder with metabolic alkalosis due to various causes in patients with multiple comorbidities and undergoing multidrug treatment. The use of diuretics for cardiovascular comorbidities was the main cause of metabolic alkalosis with hyponatremia and/or hypochloremia. Metabolic alkalosis causes a direct depression of the respiratory drive, leads to diminished chemoreceptor stimulation and consequently reduces alveolar ventilation to increase PaCO2 and lower pH toward normal levels. Metabolic alkalosis is usually associated with hypochloremia, which has a relevant inhibitory effect on the ventilatory response to hypercapnia. A reduction of serum chloride is associated with a reduced chloride concentration in the cerebrospinal fluid. Because the cerebrospinal fluid does not contain significant weak acids, a reduction of its chloride level will result in a bicarbonate increase to maintain electroneutrality, which raises the central pH and leads to hypoventilation.