Changes of Respiratory Mechanics in COPD Patients from Stable State to Acute Exacerbations with Respiratory Failure

2016 ◽  
Vol 14 (2) ◽  
pp. 150-155 ◽  
Author(s):  
Piero Ceriana ◽  
Michele Vitacca ◽  
Annalisa Carlucci ◽  
Mara Paneroni ◽  
Lara Pisani ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Respiratory Mechanics ◽  
Stable State ◽  
Copd Patients ◽  
Acute Exacerbations

scholarly journals Non-invasive positive pressure ventilation offers greater improvement in COPD-related respiratory failure when combined with naloxone

2016 ◽  
Vol 11 (2) ◽  
pp. 359
Author(s):  
Long Zhang ◽  
Wei Zhao ◽  
Qinfu Xu ◽  
Yumiao Zhao ◽  
Junjie Zhao ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Pulmonary Function ◽  
Positive Pressure Ventilation ◽  
Respiratory Mechanics ◽  
Oxygen Metabolism ◽  
Positive Pressure ◽  
Control Group ◽  
Non Invasive ◽  
Copd Patients ◽  
New Treatment

<p class="Abstract">To improve efficacy of non-invasive positive pressure ventilation (NPPV), this study investigated the combination of NPPV with naloxone in COPD patients with respiratory failure. One hundred four patients with COPD-related respiratory failure were enrolled prospectively and randomly divided into a control group treated with NPPV alone (n = 52) and an observation group treated with NPPV combined with 4.0 mg naloxone by continuous infusion (n = 52). At 3 and 5 days after the start of treatment, the respiratory mechanics, pulmonary function, and oxygen metabolism parameters were significantly improved in the NPPV + naloxone group compared to the NPPV alone group (p&lt;0.05). Further, the improvements in the NPPV plus naloxone group were greater at day 5 than at day 3 (p&lt;0.05). These findings indicate that non-invasive positive pressure ventilation combined with naloxone can more effectively improve respiratory mechanics, pulmonary function and oxygen metabolism of COPD patients with respiratory failure than NPPV alone, offering a new treatment approach.</p><p> </p>

scholarly journals A Systematic Review and Meta-Analysis of the Prevalence and Impact of Pulmonary Bacterial Colonisation in Stable State Chronic Obstructive Pulmonary Disease (COPD)

Biomedicines ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 81
Author(s):  
Michael N. Armitage ◽  
Daniella A. Spittle ◽  
Alice M. Turner
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Group Analysis ◽  
Stable State ◽  
Chronic Obstructive ◽  
Targeted Prevention ◽  
Significant Heterogeneity ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Acute Exacerbations

Background: Half of acute exacerbations of COPD are due to bacterial infection, and the other half are likely influenced by microbial colonisation. The same organisms commonly cultured during acute exacerbations are often found in the sputum of patients during stability. A robust assessment of the prevalence of potentially pathogenic microorganisms (PPMs) in the sputum of stable COPD patients may help to inform the targeted prevention of exacerbation by these organisms. Methods: A systematic review and meta-analysis was carried out to determine the prevalence of PPMs in patients with COPD in the stable state. Meta-analysis of prevalence was carried out using the Freeman–Tukey double arcsine transformation random effects model, and sub-group analysis was performed for sputum modality. Prevalence of total and individual PPMs was calculated from patient-level data from individual studies. Results: Pooled prevalence of PPMs identified by sputum culture was found to be 41% (95% CI 36–47%). Significant heterogeneity was found across all studies, which can likely be attributed to inconsistent measuring and reporting of PPMs. The most commonly reported organisms were H. influenzae, M catarrhalis, S. pneumoniae, S. aureus, and P. aeruginosa. Declining lung function was weakly correlated with prevalence of PPMs. Conclusion: The airways of patients with COPD are colonised with PPMs during the stable state in almost half of patients. A complex relationship likely exists between the microbiome in the stable state and the phenotype of COPD patients. Targeted microbial therapy for preventing exacerbations of COPD should carefully consider the stable microbiome as well as the exacerbated.

scholarly journals Impact of HACOR Score on Noninvasive Ventilation Failure in Non-COPD Patients with Acute-on-Chronic Respiratory Failure

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Min Ding ◽  
Xiaoli Han ◽  
Linfu Bai ◽  
Shicong Huang ◽  
Jun Duan
Keyword(s):  
Respiratory Failure ◽  
Sensitivity And Specificity ◽  
Noninvasive Ventilation ◽  
Rating Scale ◽  
Characteristic Curve ◽  
Respiratory Acidosis ◽  
Chronic Respiratory Failure ◽  
Chronic Obstructive ◽  
Hospital Data ◽  
Copd Patients

Background. A rating scale that takes into account heart rate, acidosis, consciousness, oxygenation, and respiratory rate (the HACOR score) has been used to predict noninvasive ventilation (NIV) failure in patients with chronic obstructive pulmonary disease (COPD). However, the HACOR score has not been used to predict NIV failure in non-COPD patients with acute-on-chronic respiratory failure. Methods. This study was performed in the respiratory intensive care unit of a teaching hospital. Data had been collected prospectively between June 2011 and January 2019. We enrolled non-COPD patients who received NIV due to acute-on-chronic respiratory failure, pH < 7.35, and PaCO2 >45 mmHg. NIV failure was defined as requiring intubation or dying during NIV. The HACOR score was determined at initiation and after 1-2, 12, and 24 h of NIV. Scores can range from 0 to 27, with higher scores indicating a higher risk of NIV failure. Results. A total of 148 patients were enrolled in the study, 52 with sleep apnea-hypopnea syndrome, 34 with chronic thoracic sequelae, 31 with bronchiectasis, 14 with chest wall deformity, 5 with obesity-hypoventilation syndrome, and 12 with other conditions. Of the patients, 19 (13%) experienced NIV failure. From initiation to 24 h of NIV, the HACOR scores of patients who experienced NIV failure were much higher than those of patients who received successful NIV. The area under the receiver operating characteristic curve was 0.69, 0.91, 0.91, and 0.94 when the HACOR score was tested at initiation and after 1-2, 12, and 24 h of NIV, respectively. To obtain the best sensitivity and specificity, the cutoff value at initiation was 7 with a sensitivity of 68% and a specificity of 61%. After 1-2 h of NIV, it was 5 with a sensitivity of 90% and a specificity of 85%. After 12 h of NIV, it was 4 with a sensitivity of 82% and a specificity of 91%. After 24 h of NIV, it was 2 with a sensitivity of 100% and a specificity of 76%. Conclusions. The HACOR score has high sensitivity and specificity for predicting NIV failure among non-COPD patients who receive NIV due to acute-on-chronic respiratory failure with respiratory acidosis.

Nasal High Flow Use in COPD Patients with Hypercapnic Respiratory Failure: Treatment Algorithm & Review of the Literature

2020 ◽  
Vol 17 (1) ◽  
pp. 101-111 ◽  
Author(s):  
Ioannis Pantazopoulos ◽  
Zoi Daniil ◽  
Melanie Moylan ◽  
Konstantinos Gourgoulianis ◽  
Athanasios Chalkias ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Treatment Algorithm ◽  
High Flow ◽  
Review Of The Literature ◽  
Hypercapnic Respiratory Failure ◽  
Failure Treatment ◽  
Copd Patients

The Severe Respiratory Insufficiency Questionnaire was valid for COPD patients with severe chronic respiratory failure

2008 ◽  
Vol 61 (8) ◽  
pp. 848-853 ◽  
Author(s):  
Wolfram Windisch ◽  
Stephan Budweiser ◽  
Frank Heinemann ◽  
Michael Pfeifer ◽  
Peter Rzehak
Keyword(s):  
Respiratory Failure ◽  
Respiratory Insufficiency ◽  
Chronic Respiratory Failure ◽  
Copd Patients

scholarly journals Effectiveness of early rehabilitation on patients with chronic obstructive lung disease and acute respiratory failure in intensive care units: A case–control study

2019 ◽  
Vol 16 ◽  
pp. 147997311882031
Author(s):  
Willy Chou ◽  
Chih-Cheng Lai ◽  
Kuo-Chen Cheng ◽  
Kuo-Shu Yuan ◽  
Chin-Ming Chen ◽  
...  
Keyword(s):  
Intensive Care ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Intensive Care Units ◽  
Case Control Study ◽  
Case Control ◽  
Early Rehabilitation ◽  
Chronic Obstructive ◽  
Copd Patients ◽  
Control Study

The effect of early rehabilitation on the outcome of patients with chronic obstructive pulmonary disease (COPD) and acute respiratory failure (ARF) in intensive care units (ICUs) remains unclear. We examined the effect of early rehabilitation on the outcomes of COPD patients requiring mechanical ventilation (MV) in the ICU. This retrospective, observational, case–control study was conducted in a medical center with a 19-bed ICU. The records of all 105 ICU patients with COPD and ARF who required MV from January to December 2011 were examined. The outcomes (MV duration, rates of successful weaning and survival, lengths of ICU and hospital stays, and medical costs) were recorded and analyzed. During the study period, 35 patients with COPD underwent early rehabilitation in the ICU and 70 demographically and clinically matched patients with similar COPD stage, cause of intubation, type of respiratory failure, and levels of disease severity who had not undergone early rehabilitation in the ICU were selected as comparative controls. Multiple regression analysis showed that early rehabilitation was significantly negatively associated with MV duration. Early rehabilitation for COPD patients in the ICU with ARF shortened the duration of their MV.

scholarly journals Antiviral immunity is impaired in COPD patients with frequent exacerbations

2019 ◽  
Vol 317 (6) ◽  
pp. L893-L903 ◽  
Author(s):  
Aran Singanayagam ◽  
Su-Ling Loo ◽  
Maria Calderazzo ◽  
Lydia J. Finney ◽  
Maria-Belen Trujillo Torralbo ◽  
...  
Keyword(s):  
Epithelial Cells ◽  
Treatment Options ◽  
Stable State ◽  
Innate Immune ◽  
Chronic Obstructive ◽  
Type I ◽  
Obstructive Pulmonary Disease ◽  
Immune Mediators ◽  
Copd Patients

Patients with frequent exacerbations represent a chronic obstructive pulmonary disease (COPD) subgroup requiring better treatment options. The aim of this study was to determine the innate immune mechanisms that underlie susceptibility to frequent exacerbations in COPD. We measured sputum expression of immune mediators and bacterial loads in samples from patients with COPD at stable state and during virus-associated exacerbations. In vitro immune responses to rhinovirus infection in differentiated primary bronchial epithelial cells (BECs) sampled from patients with COPD were additionally evaluated. Patients were stratified as frequent exacerbators (≥2 exacerbations in the preceding year) or infrequent exacerbators (<2 exacerbations in the preceding year) with comparisons made between these groups. Frequent exacerbators had reduced sputum cell mRNA expression of the antiviral immune mediators type I and III interferons and reduced interferon-stimulated gene (ISG) expression when clinically stable and during virus-associated exacerbation. A role for epithelial cell-intrinsic innate immune dysregulation was identified: induction of interferons and ISGs during in vitro rhinovirus (RV) infection was also impaired in differentiated BECs from frequent exacerbators. Frequent exacerbators additionally had increased sputum bacterial loads at 2 wk following virus-associated exacerbation onset. These data implicate deficient airway innate immunity involving epithelial cells in the increased propensity to exacerbations observed in some patients with COPD. Therapeutic approaches to boost innate antimicrobial immunity in the lung could be a viable strategy for prevention and treatment of frequent exacerbations.

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