Pneumologische Rehabilitation bei ILD: Unmittelbar effektive Verbesserung der Lebensqualität, aber wie sieht es langfristig aus?

2021 ◽  
pp. 18-20
Author(s):  
Desiree Faccioli ◽  
Marc Spielmanns
Keyword(s):  
Outcome Measures ◽  
Pulmonary Rehabilitation ◽  
Real Life ◽  
Blood Gases ◽  
Interstitial Lung Diseases ◽  
Walking Distance ◽  
Long Term Effects ◽  
Success Predictors ◽  
Antifibrotic Therapy ◽  
Arterial Blood

<b>Background and aim:</b> Benefits of pulmonary rehabilitation in Interstitial Lung Diseases (ILD) have been reported. The aim of this large multicenter study was to identify the success predictors of pulmonary rehabilitation in a real-life setting. <b>Methods:</b> Data of 240 in-patients (110 idiopathic pulmonary fibrosis (IPF), 106 ILD other than IPF and 24 undetermined ILD) undergoing pulmonary rehabilitation in a 10-year period were retrospectively evaluated. Six minute walking distance (6MWT), body weight-walking distance product tests, dyspnoea and arterial blood gases were assessed at admission and discharge. Differences in post rehabilitation changes in outcome measures as function of baseline characteristics were evaluated. <b>Results:</b>After rehabilitation, patients showed improvements in all outcome measures (p &#x3c; 0.05), regardless of the underlying diagnosis or disease severity. Patients needing oxygen therapy at rest showed reduced benefits. Baseline 6MWD inversely correlated with its changes at discharge. Non-significant greater benefits after rehabilitation were found in IPF patients under antifibrotic therapy. In a subset of 50 patients assessed on average 10.3 ± 3.5 months after discharge, the benefits in 6MWD were not maintained (312.9 ± 139.4, 369.7 ± 122.5 and 310.8 ± 139.6 m at admission, discharge and follow up respectively: <i>p</i> &#x3c; 0.0001). <b>Conclusion:</b> Pulmonary rehabilitation may improve dyspnoea, exercise capacity and fatigue in patients with ILD of different aethiologies and level of severity. The long-term effects need to be established.

COVID-19: Pneumologische Rehabilitation bei Patienten in der postakuten Phase

2021 ◽  
pp. 1-2
Author(s):  
Daniela Leitl ◽  
Andreas Rembert Koczulla
Keyword(s):  
Physical Performance ◽  
Outcome Measures ◽  
Pulmonary Rehabilitation ◽  
Real Life ◽  
Rehabilitation Program ◽  
Assisted Ventilation ◽  
Walking Distance ◽  
Retrospective Data Analysis ◽  
Real Life Setting ◽  
Pneumologische Rehabilitation

<b>Background:</b>In hospitalized patients recovering from the SARS-coronavirus-2 disease 19 (COVID-19), high prevalence of muscle weakness and physical performance impairment has been observed. <b>Objectives:</b>The aim of this study was to evaluate the effectiveness of pulmonary rehabilitation in these subjects in a real-life setting. <b>Methods:</b>Retrospective data analysis of patients recovering from COVID-19, including those requiring assisted ventilation or oxygen therapy, consecutively admitted to an in-patient pulmonary rehabilitation program between April 1 and August 15, 2020. Short Physical Performance Battery (SPPB: primary outcome), Barthel Index (BI), and six-min walking distance were assessed as outcome measures. <b>Results:</b>Data of 140 patients were analyzed. After rehabilitation, patients showed improvements in SPPB {from: (median [IQR]) 0.5 (0–7) to 7 (4–10), <i>p</i> &#x3c; 0.001} and BI (from 55 [30–90] to 95 [65–100], <i>p</i> &#x3c; 0.001), as well as in other assessed outcome measures. The proportion of patients unable at admission to stand, rise from a chair and walk was significantly reduced (<i>p</i> &#x3c; 0.00). <b>Conclusions:</b>Pulmonary rehabilitation is possible and effective in patients recovering from COVID-19. Our findings may be useful to guide clinicians taking care of patients surviving COVID-19 infection.

scholarly journals Pulmonary Rehabilitation in Patients Recovering from COVID-19

Respiration ◽  
2021 ◽  
pp. 1-7
Author(s):  
Elisabetta Zampogna ◽  
Mara Paneroni ◽  
Stefano Belli ◽  
Maria Aliani ◽  
Alessandra Gandolfo ◽  
...  
Keyword(s):  
Physical Performance ◽  
Outcome Measures ◽  
Pulmonary Rehabilitation ◽  
Real Life ◽  
Rehabilitation Program ◽  
Assisted Ventilation ◽  
Walking Distance ◽  
Retrospective Data Analysis ◽  
Real Life Setting ◽  
Performance Impairment

<b><i>Background:</i></b> In hospitalized patients recovering from the SARS-coronavirus-2 disease 19 (COVID-19), high prevalence of muscle weakness and physical performance impairment has been observed. <b><i>Objectives:</i></b> The aim of this study was to evaluate the effectiveness of pulmonary rehabilitation in these subjects in a real-life setting. <b><i>Methods:</i></b> Retrospective data analysis of patients recovering from COVID-19, including those requiring assisted ventilation or oxygen therapy, consecutively admitted to an in-patient pulmonary rehabilitation program between April 1 and August 15, 2020. Short Physical Performance Battery (SPPB: primary outcome), Barthel Index (BI), and six-min walking distance were assessed as outcome measures. <b><i>Results:</i></b> Data of 140 patients were analyzed. After rehabilitation, patients showed improvements in SPPB {from: (median [IQR]) 0.5 (0–7) to 7 (4–10), <i>p</i> &#x3c; 0.001} and BI (from 55 [30–90] to 95 [65–100], <i>p</i> &#x3c; 0.001), as well as in other assessed outcome measures. The proportion of patients unable at admission to stand, rise from a chair and walk was significantly reduced (<i>p</i> &#x3c; 0.00). <b><i>Conclusions:</i></b> Pulmonary rehabilitation is possible and effective in patients recovering from COVID-19. Our findings may be useful to guide clinicians taking care of patients surviving COVID-19 infection.

scholarly journals Impact of inspiratory muscle training on diaphragmatic mobility and arterial blood gases in patients undergoing haemodialysis

2021 ◽  
Vol 28 (5) ◽  
pp. 1-8
Author(s):  
Fatma Aboelmagd ◽  
Samah M Ismail
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Partial Pressure ◽  
Physical Function ◽  
Outcome Measures ◽  
Blood Gases ◽  
Daily Routine ◽  
Arterial Blood Gases ◽  
Arterial Partial Pressure ◽  
Arterial Blood

Background/aims Impairment of respiratory muscle function is common in patients with chronic kidney disease undergoing haemodialysis, and is manifested by decreased oxygenation and physical function. The purpose of this study was to analyse the impact of training with incentive spirometer on mobility of the diaphragm, arterial blood gases and functional capacity in patients with chronic kidney disease undergoing haemodialysis. Methods A pre–post research design was implemented. A total of 30 patients undergoing haemodialysis for chronic kidney disease received incentive spirometer training intradialysis three sessions a week for 8 weeks. Outcome measures were the amount of diaphragmatic mobility measured by ultrasonography, the levels of arterial partial pressure of oxygen, arterial partial pressure of carbon dioxide, oxygen saturation percentages and the distance walked in 6 minutes. Results Significant improvement from pre-treatment to post-treatment measurements occurred in all outcome measures, with P<0.05. Conclusions Incentive spirometer training should be recommended to be a part of daily routine of patients with chronic kidney disease who are undergoing haemodialysis to decrease respiratory and physical function impairments.

scholarly journals Is there a rationale for pulmonary rehabilitation following successful chemotherapy for tuberculosis?

2016 ◽  
Vol 42 (5) ◽  
pp. 374-385 ◽  
Author(s):  
Marcela Muñoz-Torrico ◽  
Adrian Rendon ◽  
Rosella Centis ◽  
Lia D'Ambrosio ◽  
Zhenia Fuentes ◽  
...  
Keyword(s):  
Pulmonary Rehabilitation ◽  
Blood Gases ◽  
Treatment Phase ◽  
Multidrug Resistant ◽  
Public Health Care ◽  
Diagnostic Tools ◽  
Functional Evaluation ◽  
Arterial Blood ◽  
Pubmed Search

ABSTRACT The role of tuberculosis as a public health care priority and the availability of diagnostic tools to evaluate functional status (spirometry, plethysmography, and DLCO determination), arterial blood gases, capacity to perform exercise, lesions (chest X-ray and CT), and quality of life justify the effort to consider what needs to be done when patients have completed their treatment. To our knowledge, no review has ever evaluated this topic in a comprehensive manner. Our objective was to review the available evidence on this topic and draw conclusions regarding the future role of the "post-tuberculosis treatment" phase, which will potentially affect several million cases every year. We carried out a non-systematic literature review based on a PubMed search using specific keywords (various combinations of the terms "tuberculosis", "rehabilitation", "multidrug-resistant tuberculosis", "pulmonary disease", "obstructive lung disease", and "lung volume measurements"). The reference lists of the most important studies were retrieved in order to improve the sensitivity of the search. Manuscripts written in English, Spanish, and Russian were selected. The main areas of interest were tuberculosis sequelae following tuberculosis diagnosis and treatment; "destroyed lung"; functional evaluation of sequelae; pulmonary rehabilitation interventions (physiotherapy, long-term oxygen therapy, and ventilation); and multidrug-resistant tuberculosis.The evidence found suggests that tuberculosis is definitively responsible for functional sequelae, primarily causing an obstructive pattern on spirometry (but also restrictive and mixed patterns), and that there is a rationale for pulmonary rehabilitation. We also provide a list of variables that should be discussed in future studies on pulmonary rehabilitation in patients with post-tuberculosis sequelae.

scholarly journals Using a Citizen Science Approach with German Horse Owners to Study the Locomotion Behaviour of Horses on Pasture

2020 ◽  
Vol 12 (5) ◽  
pp. 1835
Author(s):  
Anja Schmitz ◽  
Bettina Tonn ◽  
Ann-Kathrin Schöppner ◽  
Johannes Isselstein
Keyword(s):  
Land Use ◽  
Citizen Science ◽  
Agricultural Land ◽  
Agricultural Research ◽  
Real Life ◽  
Sustainable Land Use ◽  
Walking Distance ◽  
Pasture Management ◽  
Science Approach ◽  
Simple Technology

Engaging farmers as citizen scientists may be a cost-efficient way to answering applied research questions aimed at more sustainable land use. We used a citizen science approach with German horse farmers with a dual goal. Firstly, we tested the practicability of this approach for answering ‘real-life’ questions in variable agricultural land-use systems. Secondly, we were interested in the knowledge it can provide about locomotion of horses on pasture and the management factors influencing this behaviour. Out of 165 volunteers, we selected 40 participants to record locomotion of two horses on pasture and provide information on their horse husbandry and pasture management. We obtained complete records for three recording days per horse from 28 participants, resulting in a dataset on more individual horses than any other Global Positioning System study published in the last 30 years. Time spent walking was greatest for horses kept in box-stall stables, and walking distance decreased with increasing grazing time. This suggests that restrictions in pasture access may increase stress on grass swards through running and trampling, severely challenging sustainable pasture management. Our study, involving simple technology, clear instructions and rigorous quality assessment, demonstrates the potential of citizen science actively involving land managers in agricultural research.

scholarly journals Elimination of nasal obstruction improves pulmonary functions and oxygenation

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Eman Sobh ◽  
Fatma Elhussieny ◽  
Taghreed Ismail
Keyword(s):  
Nasal Obstruction ◽  
Blood Gases ◽  
Medical Problem ◽  
Forced Expiratory Volume ◽  
Nasal Packing ◽  
Nasal Pack ◽  
Arterial Blood ◽  
Study Population ◽  
The Mean ◽  
The Impact

Abstract Background Nasal obstruction is a significant medical problem. This study aimed to examine the effect of nasal obstruction and nasal packing on arterial blood gases and pulmonary function indices, and the impact of the elimination of nasal obstruction on preoperative values. Results The mean age of the study population was 26.6 ± 10.1 years, males represented 50.8%. Spirometric indices showed statistically significant improvement (preoperative forced expiratory volume in 1st second 66.9 ± 13.9 vs 79.6 ± 14.9 postoperative and preoperative forced vital capacity 65.5 ± 12.7 vs 80.4 ± 13.8 postoperative). Oxygen saturation was significantly lower during nasal packing (95.6 ± 1.6 preoperative vs 94.7 ± 2.8 with nasal pack), and significant improvement (97.2 ± 1.4) was observed after removal of the nasal pack. Nasal obstruction scores significantly improved. Conclusion The results of this study indicate that either simple nasal obstruction or nasal packing may cause hypoxemia and abnormalities in lung function tests. Hypoxemia was more evident with nasal packing.

scholarly journals Validation of Clinical Characteristics and Effectiveness of Pulmonary Rehabilitation in a COPD Population with Discrepancy between Exercise Tolerance and FEV1

Healthcare ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 53
Author(s):  
Jun Horie ◽  
Koichiro Takahashi ◽  
Shuuichi Shiranita ◽  
Kunihiko Anami ◽  
Shinichiro Hayashi
Keyword(s):  
Gait Speed ◽  
Pulmonary Rehabilitation ◽  
Exercise Tolerance ◽  
Respiratory Illness ◽  
Forced Expiratory Volume ◽  
Walking Distance ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
St George's Respiratory Questionnaire ◽  
History Of

This study’s objective was to examine the characteristics of patients with chronic obstructive pulmonary disease (COPD) presenting with various exercise tolerance levels. A total of 235 patients with stable COPD were classified into 4 groups: (1) LoFlo + HiEx—patients with a six-minute walking distance (6MWD) ≥350 m and percentage of predicted forced expiratory volume in 1 s (%FEV1.0) <50%; (2) HiFlo + HiEx—patients with a 6MWD ≥350 m and a %FEV1.0 ≥50%; (3) LoFlo + LoEx—patients with a 6MWD < 350 m and %FEV1.0 < 50%; and (4) HiFlo + LoEx—patients with a 6MWD <350 m and %FEV1.0 ≥ 50%. Aspects of physical ability in the HiFlo + LoEx group were significantly lower than those in the HiFlo + HiEx group. The HiFlo + LoEx group was characterized by a history of hospitalization for respiratory illness within the past year, treatment with at-home oxygen therapy, and lacking daily exercise habits. Following three months of pulmonary rehabilitation, the LoFlo + HiEx group significantly improved in the modified Medical Research Council dyspnea score, maximum gait speed, and 6MWD, while the HiFlo + LoEx group significantly improved in the percentage of maximal expiratory pressure, maximum gait speed, 6MWD, incremental shuttle walking distance, and St. George’s Respiratory Questionnaire score. The HiFlo + LoEx group had the greatest effect of three-month pulmonary rehabilitation compared to other groups.

scholarly journals Pathophysiology and clinical consequences of arterial blood gases and pH after cardiac arrest

2020 ◽  
Vol 8 (S1) ◽  
Author(s):  
Chiara Robba ◽  
Dorota Siwicka-Gieroba ◽  
Andras Sikter ◽  
Denise Battaglini ◽  
Wojciech Dąbrowski ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Mechanical Ventilation ◽  
Cardiac Arrest ◽  
Oxygen Demand ◽  
Blood Gases ◽  
Metabolic Energy ◽  
High Morbidity ◽  
Arterial Blood Gases ◽  
Arterial Blood ◽  
Clinical Consequences

AbstractPost cardiac arrest syndrome is associated with high morbidity and mortality, which is related not only to a poor neurological outcome but also to respiratory and cardiovascular dysfunctions. The control of gas exchange, and in particular oxygenation and carbon dioxide levels, is fundamental in mechanically ventilated patients after resuscitation, as arterial blood gases derangement might have important effects on the cerebral blood flow and systemic physiology.In particular, the pathophysiological role of carbon dioxide (CO2) levels is strongly underestimated, as its alterations quickly affect also the changes of intracellular pH, and consequently influence metabolic energy and oxygen demand. Hypo/hypercapnia, as well as mechanical ventilation during and after resuscitation, can affect CO2 levels and trigger a dangerous pathophysiological vicious circle related to the relationship between pH, cellular demand, and catecholamine levels. The developing hypocapnia can nullify the beneficial effects of the hypothermia. The aim of this review was to describe the pathophysiology and clinical consequences of arterial blood gases and pH after cardiac arrest.According to our findings, the optimal ventilator strategies in post cardiac arrest patients are not fully understood, and oxygen and carbon dioxide targets should take in consideration a complex pattern of pathophysiological factors. Further studies are warranted to define the optimal settings of mechanical ventilation in patients after cardiac arrest.

Sign in / Sign up

Export Citation Format

Share Document