scholarly journals Characteristics and outcomes in acute patients receiving mechanical ventilation in a Coronary Care Unit (CCU)

2021 ◽  
Vol 10 (Supplement_1) ◽  
Author(s):  
M Rivadeneira Ruiz ◽  
DF Arroyo Monino ◽  
T Seoane Garcia ◽  
MP Ruiz Garcia ◽  
JC Garcia Rubira
Keyword(s):  
Mechanical Ventilation ◽  
Cardiac Arrest ◽  
Hospital Mortality ◽  
Coronary Care Unit ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Funding Sources ◽  
Copd Patients ◽  
The Mean ◽  
Coronary Care

Abstract Funding Acknowledgements Type of funding sources: None. Objectives Mechanical ventilation is the short-term technical support most widely used and cardiac arrest its main indication in a Coronary Care Unit (CCU). However, the knowledge about the specific moment and ventilator mode of onset to avoid the acute lung injury is still equivocal. Our objective is to determine the survival rate and the prognostic factors in patients supported by mechanical ventilation. Methods We conducted a retrospective cohort study of adult patients admitted to the CCU between January 2018 and November 2020 that received mechanical ventilation during the hospital stay. Results We collected 94 patients, 28% females with a median age of 68 ± 11,9. 43% were diabetics and almost one quarter of them had some degree of chronic obstructive pulmonary disease (COPD). Ischemic cardiopathy (33%) and heart failure (31%) were frequent pathologies as well as renal injury (29% patients a filtration rate below 45 mL/min/1,73m2). The reason for initiating mechanical ventilation was cardiac arrest in the half of the patients. Volume-controlled ventilation (73%) was the initial setting mode in most cases. The support with vasoactive drugs were highly necessary in these patients (Infection rate of 48%). In the subgroup analysis, we realized that the number of reintubations and the necessity of non-invasive ventilation were higher in the COPD group (p = 0,01), as well as tracheostomy (p = 0,03). COPD patients also needed higher maintaining PEEP, though this was not statistically significant. The mean length of stay in the intensive care unit of our cohort was 11 days (range: 1-78 days; median: 8 days) and the mean length of mechanical ventilation 6 days (range: 1-64 days; median: 3 days). The in-hospital mortality was 41,4%. Conclusions Cardiac arrest is the most common reason of mechanical ventilation support. Our study showed that COPD patients presented more complications during the weaning and the period after extubation. In-hospital mortality remains high in intubated patients.

scholarly journals Face-to-face Training as an Effective Approach for Instructing Rotahaler Technique in Newly Diagnosed Cases of Asthma and COPD: a Pilot Study

2015 ◽  
Vol 53 (198) ◽  
pp. 150-153 ◽  
Author(s):  
Ramesh Sharma Poudel ◽  
Shakti Shrestha ◽  
Rano Mal Piryani ◽  
Aastha Prajapati ◽  
Dipendra Khatiwada
Keyword(s):  
Chronic Obstructive ◽  
Newly Diagnosed ◽  
Obstructive Pulmonary Disease ◽  
Face To Face ◽  
Copd Patients ◽  
Study Population ◽  
The Mean ◽  
Gina Guidelines ◽  
Keywords Asthma ◽  
First Time

Introduction: This study aimed to evaluate the effectiveness of face-to-face training for instructing rotahaler technique in newly diagnosed cases of asthma and chronic obstructive pulmonary disease. Methods: A hospital-based study was conducted on twenty patients who were prescribed rotahaler for the first time. Patients received face-to-face training on rotahaler technique from pharmacist using GINA guidelines. The patients rotahaler technique was assessed after two weeks of training and scored one for correct and zero for incorrect steps. Descriptive statistics was performed. Results: The mean age of the study population was 48.85±20.49 years. Eleven (55%) patients were females and 13 (65%) were formally uneducated. Fourteen patients (70%) were able to perform all the steps correctly giving overall median score of 8 (7-8). Conclusions: Face-to-face training seems to be effective approach for instructing rotahaler technique in asthma and COPD patients.  Keywords: asthma; COPD; face-to-face training; inhaler technique; pharmacist.

scholarly journals Health-Related Quality Of Life, Uncertainty, ‎and Anxiety among Patients with Chronic Obstructive Pulmonary Disease

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 420
Author(s):  
Nazih Abu Tabar ◽  
Mohammad Al Qadire ◽  
Imad Thultheen ◽  
Jafar Alshraideh
Keyword(s):  
Quality Of Life ◽  
Chronic Obstructive Pulmonary Disease ◽  
Chronic Obstructive ◽  
Health Related Quality ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Related Quality ◽  
Health Related ◽  
The Mean

Patients’ with Chronic Obstructive Pulmonary Disease suffer from serious respiratory symptoms that increase anxiety, stress, and uncertainty, and affect quality of life. The aim of this study was to assess level of anxiety, uncertainty, and health related quality of life (HRQoL) among COPD patients in Jordan. Correlational cross-sectional survey design was used to collect data from 153 COPD patients. ‎The study was conducted at pulmonary clinics in three major referral hospitals in Jordan that provide care for COPD patients from different parts of the country. To assess HRQoL, St. George ‎Respiratory Questionnaire‎ was completed. Uncertainty and anxiety level was measured by Mishel's uncertainty of illness scale and state anxiety inventory respectively. The mean age of participants was 66.8 (SD= 10.3) and most participants were males (94.1%) with. The mean score of HRQoL was 57.9 (SD = 20.5). The mean score of participants’ level of anxiety was 38.1 (SD = 11.1). The mean score of uncertainty was 66.1 (SD= 11.1). There is a statistically significant positive relationship between HRQoL and anxiety (r =.433, p< .01), and uncertainty (r=.483, p<.01). Increased anxiety and uncertainty among COPD patients was associated with low HRQoL. Health care providers need to pay attention the effect of anxiety and uncertainty on COPD patients’ quality of life and institute appropriate management.

scholarly journals Lipid Profile Status of Chronic Obstructive Pulmonary Disease in Hospitalized Patients

2013 ◽  
Vol 3 (2) ◽  
pp. 42-45 ◽  
Author(s):  
K Begum ◽  
MK Begum ◽  
ZH Sarker ◽  
MRK Dewan ◽  
MJH Siddique
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Total Cholesterol ◽  
Pulmonary Disease ◽  
Mean Value ◽  
High Density Lipoproteins ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Healthy Control ◽  
The Mean

The aim of this study was to evaluate the serum level of total cholesterol, triglycerides (TG), low density lipoproteins (LDL) and high density lipoproteins, (HDL) in chronic obstructive pulmonary disease (COPD) patients admitted in National Institute of Disease of Chest and Hospital, Mohakhali, Dhaka during. January 2009 to January 2010. Twenty two patients with COPD and 22 healthy controls were included in this study. Total cholesterol, HDL and TG levels were determined with ILAB 1800 Chemistry Analyzer using ILAB test Reagents. LDL concentration was calculated using the Friedewald Equation. The mean level of TG was 150.04±29.66 mg/dl and 126.14±13.28 in COPD patients and healthy control, respectively. A statistically significant difference was found between the two groups (p<0.001). The mean level of TC was 181.83±20.11 mg/dl and 176.28±15.35 mg/dl in COPD patients and healthy control respectively (p<0.001). LDL level mean value was 116.12±14.26 mg/dl and 108.95±10.39 in COPD patients and control respectively (p<0.001). The mean value of HDL showed 38.79±2.4 in COPD patients and 39.014±1.56 in control. A statistically significance was also found between the two groups (p<0.001). Our results showed that the values of TC, TG, LDL were higher than healthy control that is highly significant statistically. On the other hand, the was significantly decreased HDL level compared with controls. DOI: http://dx.doi.org/10.3329/bjmb.v3i2.13810 Bangladesh J Med Biochem 2010; 3(2): 42-45

Accuracy of tidal volume, lung volume, and flow measurements by inductance vest in COPD patients

1984 ◽  
Vol 56 (6) ◽  
pp. 1659-1665 ◽  
Author(s):  
D. W. Hudgel ◽  
M. Capehart ◽  
B. Johnson ◽  
P. Hill ◽  
D. Robertson
Keyword(s):  
Tidal Volume ◽  
Lung Volume ◽  
Chronic Obstructive ◽  
Flow Measurements ◽  
Obstructive Pulmonary Disease ◽  
Mean Error ◽  
Copd Patients ◽  
Residual Capacity ◽  
The Mean ◽  
Thoracic And Abdominal

We analyzed the accuracy of the inductance vest in measuring several ventilatory parameters in five patients with chronic obstructive pulmonary disease (COPD). We assessed tidal volume (VT) accuracy at different respiratory frequencies in different lying body positions with different thoracic and abdominal contributions to breathing and the accuracy over a 4-h time span. Mean percent error was calculated without regard to direction of error. The mean error of vest VT estimation was 7.6% for all body positions studied and 5.6% for right and left lateral positions combined. Vest VT accuracy was unchanged after 4 h and with changes in thoracic and abdominal contributions to VT. The mean errors for inspiratory and expiratory times were 3.3 and 2.0%, respectively. Volume was differentiated to flow. For respiratory rates ranging from 12 to 30 breaths/min, the mean error of the vest and our differentiation circuit in duplicating peak flows measured at the mouth was 3.5%. The ability of the vest to estimate changes in end-expiratory position or functional residual capacity was not as good as with VT; the mean error was 30.7%. For estimation of VT, ventilatory timing, and airflow in COPD patients, the inductance vest performs well. For measurement of changes in lung volume, improvements in vest design need to be made.

scholarly journals The usefulness of Shock Index and Modified Shock Index in predicting outcome of COVID-19 patients

2021 ◽  
pp. 1-16
Author(s):  
Erdem KURT ◽  
Suphi BAHADIRLI
Keyword(s):  
Hospital Mortality ◽  
Operating Characteristic ◽  
Area Under The Curve ◽  
Male Gender ◽  
Chronic Obstructive ◽  
Shock Index ◽  
Obstructive Pulmonary Disease ◽  
Predicting Outcome ◽  
The Mean ◽  
Artery Disease

Abstract Objective: The aim of this study is to investigate the accuracy of shock index (SI) and modified shock index (mSI) in predicting intensive care unit (ICU) requirement and in-hospital mortality among COVID-19 patients who admitted to the emergency department (ED). Likewise, the effects of patients’ conditions such as age, gender and comorbidity on prognosis will be analyzed. Methods: The files were retrospectively scanned for all COVID-19 patients over the age of 18 who were admitted to the ED and hospitalized between January 1, 2021 and March 15, 2021. The area under the receiver operating characteristic (ROC) curve and the area under the curve (AUC) were used to assess each scoring system discriminatory for predicting in-hospital mortality and ICU admission. Results: There were 464 patients included in this study. The mean age of the patients was 62.4±16.7, of which 245 were men and 219 were women. The most common comorbidity in patients was hypertension 200 (43.1%), followed by chronic obstructive pulmonary disease 174 (37.5%) and coronary artery disease 154 (33.2%). In terms of in-hospital mortality, the AUC of SI, and mSI were 0.719, and 0.739, respectively. In terms of ICU requirement, the AUC of SI, and mSI were 0.704, and 0.729, respectively. Conclusions: In this study, it was concluded that SI and mSI are useful in predicting in-hospital mortality and ICU requirement in COVID-19 patients. In addition, it is another important result of the study that advanced age, male gender and hypertension may be associated with poor prognosis.

scholarly journals Mechanical Ventilation for Patients with COPD

2021 ◽  
Author(s):  
Ozlem Ediboglu
Keyword(s):  
Mechanical Ventilation ◽  
Prolonged Mechanical Ventilation ◽  
Clinical Signs ◽  
Optimal Time ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Non Invasive ◽  
Copd Patients ◽  
Appropriate Treatment ◽  
Exacerbation Of Copd

Mechanical ventilation is a lifesaving therapy in patients who have acute respiratory failure due to chronic obstructive pulmonary disease (COPD). Mechanical ventilaton either invasive or non-invasive has an important role in the management of acute exacerbation of COPD (AECOPD). AECOPD required hospitalizaton had increased mortality and poor prognosis. Ventilatory management success related to understanding physiopathology of the disease. Clinicians must be aware of deterioration of clinical signs of COPD patients. The most appropriate treatment should be performed at optimal time. Some COPD patients are at high risk for prolonged mechanical ventilation due to COPD is a progressive disease.

scholarly journals Precipitating causes and outcomes of chronic obstructive pulmonary disease exacerbation at a tertiary care center in northeast Thailand

2014 ◽  
Vol 8 (2) ◽  
pp. 229-236 ◽  
Author(s):  
Wipa Reechaipichitkul
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Respiratory Failure ◽  
Tract Infection ◽  
Respiratory Tract ◽  
Acute Exacerbation ◽  
Chronic Obstructive ◽  
Copd Exacerbation ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
The Mean

Abstract Background: Acute exacerbation of chronic obstructive pulmonary disease (COPD) is a leading cause of hospitalization and economic burden. Frequent exacerbations impair quality of life and effect decline of lung function. Objective: We evaluated characteristics of COPD patients with frequent exacerbations. The precipitating causes, outcomes, hospital stay, and cost of admission were also determined. Methods: The study population included COPD patients admitted because of acute COPD exacerbation at Srinagarind Hospital between 1 January 2006 and 31 December 2010. Results: Over the 5-year period, 183 patients were admitted. Their mean age was 74.9 (SD 9.28) years and the male to female ratio was 170:13. Most patients (144; 79%) had one exacerbation per year and 39 (21%) had more than one per year. The group with more exacerbations, had a higher stage of the disease than those with only one exacerbation (p = 0.023), but there was no significant difference in the mortality rate (18% vs 14%, p = 0.53). A total of 245 episodes of acute exacerbation of COPD occurred in 183 patients. The mean duration of symptoms was 4.1 (SD 3.46) days. Forty-seven percent presented with Anthonisen type III, 42.4% with Anthonisen type II, and 10.6% with Anthonisen type I exacerbations. For 44 exacerbations (18%), the precipitating causes were not determined. The most common precipitating cause was pneumonia, which occurred in 90 episodes (36.7%). The second common was bronchitis (27.8%); followed by heart failure (8.2%), infected bronchiectasis (5.3%), diarrhea (1.2%), acute urinary retention (0.8%), unstable angina (0.4%), pneumothorax (0.4%), urinary tract infection (0.4%), atrial fibrillation (0.4%) and drug induced cough (0.4%). The organisms responsible for respiratory tract infection were identified in 31% cases of pneumonia and 18% of bronchitis cases. The top three common pathogens for pneumonia were Pseudomonas aeruginosa (9%), Acinetobacter baumannii (8%), and Klebsiella pneumoniae (8%). The top three common pathogens for bronchitis were P aeruginosa (7%), Haemophilus influenza (6%), and K pneumoniae (4%). About one quarter (25.3%) of acute exacerbations were complicated by respiratory failure. The mean duration of admission was 17.3 days (range 1-682 days). The mean cost of admission per exacerbation was 80,010 Thai baht (US $2,666) (range, 2,779-3,433,108 baht). The total cost for 245 exacerbations was 19.6 million baht ($653,000). Conclusion: Respiratory tract infections were common causes of COPD exacerbation and one quarter of which developed respiratory failure. Preventive measures such as vaccination, smoking cessation, lung rehabilitation, and appropriate drug use are helpful.

scholarly journals Effect of Tiotropium on Post Pulmonary TB Patients With Obstructive Abnormalities to Lung Function and Quality of Life

2019 ◽  
Vol 38 (4) ◽  
pp. 203-9
Author(s):  
Romaito Nasution ◽  
Irvan Medison ◽  
Deddy Herman ◽  
Masrul Basyar
Keyword(s):  
Quality Of Life ◽  
Lung Function ◽  
Pulmonary Function ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Tb Treatment ◽  
Copd Patients ◽  
Post Test ◽  
The Mean

Background: Post pulmonary tuberculosis (TB) patients could experience pulmonary function declines which affected their quality of life. Obstrucitve abnormalities were found the most after complete TB treatment and the therapeutic guidelines focused in bronchodilators. The use of bronchodilators could improve lung function and quality of life in post TB patients with obstructive abnormalities. Tiotropium is a bronchodilator that has been shown to be effective in chronic obstructive pulmonary disease (COPD) patients, while its use in post TB patients has not been widely studied. Methods: This study design was a clinical trial with pre and post test design in post TB patients in Dr.M.Djamil Padang General Hospital and Lubuk Alung Pulmonary Hospital conducted from November 2016 to June 2017. Results: Of 30 post TB patients, the mean age was 62.77±10.99 years, most were male (63.33%), non-smokers and former smokers (50% each), had interval from complete anti TB drugs to study ≥6 months (53.3%), and moderate level of obstruction (80%). Pulmonary function prior to tiotropium was generally in moderate obstruction (FEV1 68,85±15,77). The mean quality of life prior to tiotropium was 18.27±10.81. There was no improvement in pulmonary function of post TB patients after administration of tiotropium, P=0.920, however, there was an improvement in the quality of life, P=0.009. No adverse events were found in this study. Conclusions: Administration of 2 months tiotropium in post TB patients had no effects on the improvements of lung function but improved the quality of life. More studies were needed using more patients and longer duration of administration. (J Respir Indo. 2018; 38: 203-9)

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