Role of Capnograghy during weaning from mechanical ventilation in patients with chronic obstructive pulmonary disease

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ramy Karem Ali Ali ◽  
Yasser Mosafa Mohammed Mostafa ◽  
Tamer Mohammed Ali

Abstract Background Chronic obstructive pulmonary disease (COPD) is characterized by persistent airflow limitation associated with an enhanced chronic inflammatory response in the airway, acute exacerbations of COPD can lead to progressive respiratory failure necessitating mechanical ventilation. Weaning of these patients may prove difficult and a spontaneous breath trial should be provided before the decision of extubation. Aim To evaluate the role of capnograghy in COPD patients during weaning from mechanical ventilation. Subject and methods This was a cross sectional prospective study conducted on 50 patients who were admitted at the Respiratory Intensive Care Unit of Abbassia Chest hospital and diagnosed as COPD and on mechanical ventilation. During the weaning trial, the role of capnography device evaluated considering the ability of Pet CO2 parameter in predicting hypercapnia and subsequently weaning outcome Results The changes in ABG reading before and after the SBT, PaCO2 and Pet CO2 showed significant elevation at the end of SBT,P=0.001 for both, while O2 saturation was significantly decrease at the end of SBT, P0.001. Conclusion The study found that Pa CO2 and PetCO2 are correlated to each other before, during and after SBT. Most of the studies that was found reported that PetCO2 is highly correlated with Paco2 and that PetCO2 may be a rapid and reliable predictor of arterial PaCO2 in respiratory distress.

2016 ◽  
Vol 2016 ◽  
pp. 1-15 ◽  
Author(s):  
Adam Jerzy Białas ◽  
Przemysław Sitarek ◽  
Joanna Miłkowska-Dymanowska ◽  
Wojciech Jerzy Piotrowski ◽  
Paweł Górski

Chronic obstructive pulmonary disease (COPD) is a common preventable and treatable disease, characterized by persistent airflow limitation that is usually progressive and associated with an enhanced chronic inflammatory response in the airways and the lung to noxious particles or gases. The major risk factor of COPD, which has been proven in many studies, is the exposure to cigarette smoke. However, it is 15–20% of all smokers who develop COPD. This is why we should recognize the pathobiology of COPD as involving a complex interaction between several factors, including genetic vulnerability. Oxidant-antioxidant imbalance is recognized as one of the significant factors in COPD pathogenesis. Numerous exogenous and endogenous sources of ROS are present in pathobiology of COPD. One of endogenous sources of ROS is mitochondria. Although leakage of electrons from electron transport chain and forming of ROS are the effect of physiological functioning of mitochondria, there are various intra- and extracellular factors which may increase this amount and significantly contribute to oxidative-antioxidative imbalance. With the coexistence with impaired antioxidant defence, all these issues lead to oxidative and carbonyl stress. Both of these states play a significant role in pathobiology of COPD and may account for development of major comorbidities of this disease.


2021 ◽  
Vol 10 (13) ◽  
pp. 2889
Author(s):  
Klára Szalontai ◽  
Nikolett Gémes ◽  
József Furák ◽  
Tünde Varga ◽  
Patrícia Á. Neuperger ◽  
...  

Chronic obstructive pulmonary disease (COPD), the frequently fatal pathology of the respiratory tract, accounts for half a billion cases globally. COPD manifests via chronic inflammatory response to irritants, frequently to tobacco smoke. The progression of COPD from early onset to advanced disease leads to the loss of the alveolar wall, pulmonary hypertension, and fibrosis of the respiratory epithelium. Here, we focus on the epidemiology, progression, and biomarkers of COPD with a particular connection to lung cancer. Dissecting the cellular and molecular players in the progression of the disease, we aim to shed light on the role of smoking, which is responsible for the disease, or at least for the more severe symptoms and worse patient outcomes. We summarize the inflammatory conditions, as well as the role of EMT and fibroblasts in establishing a cancer-prone microenvironment, i.e., the soil for ‘COPD-derived’ lung cancer. We highlight that the major health problem of COPD can be alleviated via smoking cessation, early diagnosis, and abandonment of the usage of biomass fuels on a global basis.


Author(s):  
Amrit Sharma

Chronic obstructive pulmonary disease (COPD) is defined as persistent airflow limitation that is usually progressive and associated with an enhanced chronic inflammatory response in the airways and the lung to noxious particles or gases. It has been suggested that emotional disturbances such as depression and anxiety are common among patients with COPD. This review aims to highlight the presence of depression and associated risk factors among patients suffering from COPD in Asia. Fifty-eight observational studies were retrieved through data sources like PubMed, Medical subject heading (MeSH) search and Google scholar. After thorough screening total thirteen studies were identified and included in this review. Based on the results of these studies, the south and west Asian countries had higher proportion of depression. However, risk factor results were mixed which includes severity of obstruction/global initiative for obstructive lung disease (GOLD) criteria, Stage 2 COPD, teetotallers, smoking, alcohol consumption, body mass index, airflow obstruction, dyspnoea, and exercise (BODE) index, urban residence, female gender, education level, dyspnoea, low income, poor Quality of life (QOL) scores, age, poor self-reported health, basic activity of daily living (BADL) disability. Further superior research studies with larger sample size are required on Asian population. All in all, it is recommended that early diagnosis and treatment of depression should be included as a part of management in COPD as it can help to minimize the risk of morbidity and mortality in the patients.


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