Medical Management Considerations for Patients With Lung Transplantation

2001 ◽  
Vol 14 (4) ◽  
pp. 258-276 ◽  
Author(s):  
Robert E. Dupuis ◽  
David J. Taber ◽  
Amy L. Fann ◽  
Kevin P. Lumbert
Keyword(s):  
Lung Transplantation ◽  
Immunosuppressive Agents ◽  
Chronic Obstructive ◽  
Drug Induced ◽  
Obstructive Pulmonary Disease ◽  
Drug Regimens ◽  
Short And Long Term ◽  
End Stage

Lung transplantation has become an accepted modality for the treatment of end-stage lung disease. Adult and pediatric patients with a variety of lung diseases, including cystic fibrosis, chronic obstructive pulmonary disease, and idiopathic pulmonary fibrosis are candidates for lung transplantation. Lung transplantation can extend survival and improve quality of life for these patients. With the introduction of new immunosuppressive agents and enhanced surgical and medical care, both short- and long-term morbidity and mortality in these populations, although not as good as other transplant types, are improving. After lung transplantation, recipients continue to face a number of obstacles including post-operative complications, complex drug regimens, drug-induced toxicities, infection, and rejection. An understanding of the management and monitoring issues after lung transplantation is the focus of this review.

The Effect of Telerehabilitation on Quality of Life, Exercise Capacity, and Spirometry Indexes in Patients with Chronic Obstructive Pulmonary Disease in Masih Daneshvari Hospital

2021 ◽  
Author(s):  
Somayeh Ghadimi ◽  
Atefeh Fakharian ◽  
Mohsen Abedi ◽  
Reyhaneh Zahiri ◽  
Mahsan Norouz Afjeh ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Control Group ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
And Control

Background: Chronic Obstructive Pulmonary Disease (COPD) leads to limited activity and reduced quality of life. Treatment of this disease is a long-term process that requires the cooperation of patients in monitoring and treatment. Methods: In the present study which was conducted from April 2019 to March 2021 in Masih Daneshvari Hospital, Tehran, Iran, 75 patients were randomly divided into telerehabilitation and control groups. Patients in the control group received pulmonary rehabilitation including respiratory, isometric, and aerobic exercises for 8 weeks, three times per week. In the second group, patients were given a lung rehabilitation booklet and asked to repeat the exercises three times a week for four weeks according to a specific schedule. In addition, patients installed Behzee care application on the mobile phone that recorded various indicators such as heart rate, SpO2, dyspnea, fatigue, and daily activities. This application reminded the patient of the program every day and at a specific time. Finally, the patients’ conditions were compared in the two groups after 8 weeks using CAT and mMRC questionnaires and 6-Minute Walk (6MW) exercise indices as well as spirometry tests. Results: In all four indicators (6MW, CAT,  and mMRC questionnaires as well as spirometry), patients showed improvement after rehabilitation (p<0.001). This improvement was significantly higher in the telemedicine group compared to the other group (p<0.01). Conclusion: The use of telerehabilitation in COPD patients is effective in improving spirometry indices, quality of life, as well as activity and sports indices.

Care of adults with long-term conditions

2020 ◽  
pp. 597-676
Keyword(s):  
Varicose Veins ◽  
Healthcare Providers ◽  
Motor Neurone ◽  
Chronic Obstructive ◽  
Long Term Conditions ◽  
Obstructive Pulmonary Disease ◽  
Lower Back ◽  
Respiratory Conditions

Multiple comorbidities necessitate care from a number of healthcare providers. Continuity of care is important for both patient satisfaction and quality of life. This chapter outlines primary care for adults with a variety of conditions, including osteoarthritis, rheumatoid arthritis, lower back pain, asthma and acute asthma, and stable and chronic obstructive pulmonary disease. It covers drugs commonly used in the treatment of respiratory conditions, including long-term oxygen and nebulizers. It then goes on to cover coronary heart disease, angina, hypertension, cardiac rehabilitation, heart failure, abnormal cardiac rhythms and atrial fibrillation, patients on anticoagulant therapies, and drugs used in cardiovascular diseases. The chapter also includes information on anaemia, varicose veins, diabetes, multiple sclerosis, motor neurone disease, and Parkinson’s disease.

Case Discussions in Advanced Care Planning

2020 ◽  
pp. 104990912094849
Author(s):  
Regine Krechowicz ◽  
Melini Gupta ◽  
Valerie Gratton ◽  
Carly Hickey ◽  
Laura H. Thompson ◽  
...  
Keyword(s):  
Life Experience ◽  
Chronic Obstructive ◽  
Care Planning ◽  
Advanced Care Planning ◽  
Obstructive Pulmonary Disease ◽  
Case Discussions ◽  
End Stage ◽  
Valuable Role

Background: Advanced care planning (ACP) provides an opportunity for individuals to explore and document their values concerning medical care decisions prior to an acute event. This manuscript explores the value of ACP and compares and contrasts 2 ACP models currently in practice. Methods: This hypothetical case describes an elderly, frail patient with end-stage chronic obstructive pulmonary disease who is also a high user of health care resources. A new palliative care-led outpatient ACP clinic model is described using this example. Results: Using the ACP clinic model in this case reveals how different a patient’s end of life experience may be when proper, proactive planning measures are in place. With proper education and discussion around this patient and family’s wishes pertaining to the end of his life, this man was able to change his plan of care from aggressive resuscitation treatment in hospital to a peaceful palliative experience at home. Conclusions: In this case description, the valuable role of ACP in preserving quality of life for patients, increasing satisfaction with care, and decreasing distress among family members during a medical event is demonstrated.

scholarly journals The patients with severe Chronic Obstructive Pulmonary Disease and chronic respiratory insufficiency

2016 ◽  
Vol 67 (3) ◽  
Author(s):  
N. Ambrosino ◽  
M. Di Giorgio ◽  
A. Di Paco
Keyword(s):  
Exercise Capacity ◽  
Chronic Obstructive Lung Disease ◽  
Supplemental Oxygen ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Chronic Respiratory Insufficiency ◽  
Global Initiative ◽  
End Stage

Caring for patients with Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages III and IV with chronic respiratory failure is difficult independent of whether the target is survival or quality of life (QOL). The role of inhaled drug therapy in this specific set of very severe COPD patients has not previously been assessed. The only drug able to prolong survival in these patients is long term oxygen therapy, whereas there is little evidence to indicate long term domiciliary mechanical ventilation in the routine management of stable hypercapnic patients. Supplemental oxygen during exercise reduces exercise breathlessness and improves exercise capacity of the hypoxaemic patient. Pulmonary rehabilitation including nutritional supplementation is a significant component of therapy, even in these severe patients. Relief of dyspnoea with drugs such as morphine should not be denied to severely disabled patients who share poor QOL with cancer patients. Non-invasive ventilation has been used as a palliative treatment to reduce dyspnoea. Lung Volume Reduction Surgery may improve mortality, exercise capacity, and QOL in selected patients, but is associated with significant morbidity and an early mortality rate in the most severe patients. Lung transplantation is a final step in end-stage patients, but short- and long-term outcomes remain significantly inferior in relation to other “solid” organs recipients.

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