2026-10-10T16:09:55Z https://api.figshare.com/v2/oai

oai:figshare.com:article/33938142 2026-09-18T17:37:24Z category_8 category_12 category_13 category_14 category_21 category_24 category_873 category_61 category_64 category_128 category_132 category_133 category_134 portal_5 item_type_3 month_year_09_2026

<p>Data anonymized.</p> Isamu Yamakawa (306831) Ryota Tamura (2216419) Hiroyuki Yabata (15391909) Takahito Tsukamoto (25073268) Shuhei Kobashi (17352784) Yoshitaka Tamaki (14573781) Nobuhiro Ogawa (511028) Akihiro Kitamura (356907) Makoto Urushitani (108130) Microbiology Cell Biology Genetics Molecular Biology Biotechnology Evolutionary Biology Chemical Sciences not elsewhere classified Developmental Biology Cancer Hematology Infectious Diseases Plant Biology Virology routine blood tests l demonstrated sensitivity blood gas parameters arterial blood gas amyotrophic lateral sclerosis 116 paired samples negative predictive value l provides specificity l achieved specificity serum electrolyte data 45 mmhg ), noninvasive screening marker cl value serves significantly higher na 45 mmhg screening marker cl value serum sodium respiratory failure leading cause investigated whether frequent monitoring examined relationships early detection could serve chloride difference analyzed correlations 90 %. 842 ). 75 %. 39 meq 37 meq <div> <p>Background</p><p>Respiratory failure is the leading cause of death in amyotrophic lateral sclerosis (ALS). Early detection of CO₂ 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 CO₂ 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 (HCO₃⁻, PCO₂), performed receiver operating characteristic (ROC) analysis for detecting CO₂ retention (PCO₂ ≥ 45 mmHg), and examined relationships with respiratory function (%FVC).</p> <p>Results</p><p>Na-Cl value showed strong correlation with HCO₃⁻ (r = 0.78, p < 0.001) and PCO₂ (r = 0.71, p < 0.001). Na-Cl ≥ 37 mEq/L demonstrated sensitivity of 85.11% and specificity of 69.57% for detecting PCO₂ ≥ 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, PCO₂, and HCO₃⁻ values.</p> <p>Conclusions</p><p>Serum Na-Cl value serves as a simple, noninvasive screening marker for CO₂ 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> 2026-09-18T17:37:18Z Dataset Dataset 10.1371/journal.pone.0358772.s003 https://figshare.com/articles/dataset/_p_Data_anonymized_p_/33938142 CC BY 4.0