scholarly journals Acid-Base Disorders in Patients with Chronic Obstructive Pulmonary Disease: A Pathophysiological Review

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Cosimo Marcello Bruno ◽  
Maria Valenti
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Side Effects ◽  
Mortality Rate ◽  
Pulmonary Disease ◽  
Correct Diagnosis ◽  
Respiratory Acidosis ◽  
Chronic Obstructive ◽  
Acid Base ◽  
Obstructive Pulmonary Disease ◽  
Mixed Acid

The authors describe the pathophysiological mechanisms leading to development of acidosis in patients with chronic obstructive pulmonary disease and its deleterious effects on outcome and mortality rate. Renal compensatory adjustments consequent to acidosis are also described in detail with emphasis on differences between acute and chronic respiratory acidosis. Mixed acid-base disturbances due to comorbidity and side effects of some drugs in these patients are also examined, and practical considerations for a correct diagnosis are provided.

scholarly journals Acid–base balance, serum electrolytes and need for non-invasive ventilation in patients with hypercapnic acute exacerbation of chronic obstructive pulmonary disease admitted to an internal medicine ward

2016 ◽  
Vol 11 ◽  
Author(s):  
Alfonso Schiavo ◽  
Maurizio Renis ◽  
Mario Polverino ◽  
Arcangelo Iannuzzi ◽  
Francesca Polverino
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Respiratory Acidosis ◽  
Chronic Obstructive ◽  
Invasive Ventilation ◽  
Internal Medicine Ward ◽  
Acid Base ◽  
Obstructive Pulmonary Disease ◽  
Non Invasive ◽  
Non Invasive Ventilation

Background: Hypoventilation produces or worsens respiratory acidosis in patients with hypercapnia due to acute exacerbations of chronic obstructive pulmonary disease (AECOPD). In these patients acid–base and hydroelectrolite balance are closely related. Aim of the present study was to evaluate acid–base and hydroelectrolite alterations in these subjects and the effect of non-invasive ventilation and pharmacological treatment. Methods: We retrospectively analysed 110 patients consecutively admitted to the Internal Medicine ward of Cava de’ Tirreni Hospital for acute exacerbation of hypercapnic chronic obstructive pulmonary disease. On admission all patients received oxygen with a Venturi mask to maintain arterial oxygen saturation at least >90 %, and received appropriate pharmacological treatment. Non-Invasive Ventilation (NIV) was started when, despite optimal therapy, patients had severe dyspnea, increased work of breathing and respiratory acidosis. Based on Arterial Blood Gas (ABG) data, we divided the 110 patients in 3 groups: A = 51 patients with compensated respiratory acidosis; B = 36 patients with respiratory acidosis + metabolic alkalosis; and C = 23 patients with respiratory acidosis + metabolic acidosis. 55 patients received only conventional therapy and 55 had conventional therapy plus NIV. Results: The use of NIV support was lower in the patients belonging to group B than in those belonging to group A and C (25 %, vs 47 % and 96 % respectively; p < 0.01). A statistically significant association was found between pCO2 values and serum chloride concentrations both in the entire cohort and in the three separate groups. Conclusions: Our study shows that in hypercapnic respiratory acidosis due to AECOPD, differently from previous studies, the metabolic alkalosis is not a negative prognostic factor neither determines greater NIV support need, whereas the metabolic acidosis in addition to respiratory acidosis is an unfavourable element, since it determines an increased need of NIV and invasive mechanical ventilation support.

Acid-Base Balance and Oxygen Tension During Dialysis in Uremic Patients With Chronic Obstructive Pulmonary Disease

2008 ◽  
Vol 32 (12) ◽  
pp. 973-977 ◽  
Author(s):  
Simone Manca-Di-Villahermosa ◽  
Michela Tedesco ◽  
Maurizio Lonzi ◽  
Francesca R. Della-Rovere ◽  
Anna Innocenzi ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Oxygen Tension ◽  
Chronic Obstructive ◽  
Acid Base Balance ◽  
Acid Base ◽  
Obstructive Pulmonary Disease ◽  
Base Balance ◽  
Uremic Patients

scholarly journals Tanimilast, A Novel Inhaled Pde4 Inhibitor for the Treatment of Asthma and Chronic Obstructive Pulmonary Disease

2021 ◽  
Vol 12 ◽  
Author(s):  
Fabrizio Facchinetti ◽  
Maurizio Civelli ◽  
Dave Singh ◽  
Alberto Papi ◽  
Aida Emirova ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Side Effects ◽  
Pulmonary Disease ◽  
Respiratory Diseases ◽  
Pde4 Inhibitor ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Chronic Respiratory Diseases ◽  
Copd Patients ◽  
Anti Inflammatory

Chronic respiratory diseases are the third leading cause of death, behind cardiovascular diseases and cancer, affecting approximately 550 million of people all over the world. Most of the chronic respiratory diseases are attributable to asthma and chronic obstructive pulmonary disease (COPD) with this latter being the major cause of deaths. Despite differences in etiology and symptoms, a common feature of asthma and COPD is an underlying degree of airways inflammation. The nature and severity of this inflammation might differ between and within different respiratory conditions and pharmacological anti-inflammatory treatments are unlikely to be effective in all patients. A precision medicine approach is needed to selectively target patients to increase the chance of therapeutic success. Inhibitors of the phosphodiesterase 4 (PDE4) enzyme like the oral PDE4 inhibitor roflumilast have shown a potential to reduce inflammatory-mediated processes and the frequency of exacerbations in certain groups of COPD patients with a chronic bronchitis phenotype. However, roflumilast use is dampened by class related side effects as nausea, diarrhea, weight loss and abdominal pain, resulting in both substantial treatment discontinuation in clinical practice and withdrawal from clinical trials. This has prompted the search for PDE4 inhibitors to be given by inhalation to reduce the systemic exposure (and thus optimize the systemic safety) and maximize the therapeutic effect in the lung. Tanimilast (international non-proprietary name of CHF6001) is a novel highly potent and selective inhaled PDE4 inhibitor with proven anti-inflammatory properties in various inflammatory cells, including leukocytes derived from asthma and COPD patients, as well as in experimental rodent models of pulmonary inflammation. Inhaled tanimilast has reached phase III clinical development by showing promising pharmacodynamic results associated with a good tolerability and safety profile, with no evidence of PDE4 inhibitors class-related side effects. In this review we will discuss the main outcomes of preclinical and clinical studies conducted during tanimilast development, with particular emphasis on the characterization of the pharmacodynamic profile that led to the identification of target populations with increased therapeutic potential in inflammatory respiratory diseases.

Teaching inhaler technique

2020 ◽  
Vol 2 (5) ◽  
pp. 234-237 ◽  
Author(s):  
Jane Scullion
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Side Effects ◽  
Pulmonary Disease ◽  
Healthcare Professionals ◽  
Simple Approach ◽  
Chronic Obstructive ◽  
Inhaler Technique ◽  
Obstructive Pulmonary Disease ◽  
Practical Advice

Inhalers were developed to deliver required medications directly to the lungs whilst minimising any side effects. They are the key to managing exacerbations and symptoms in both asthma and chronic obstructive pulmonary disease but are not yet proven to prevent mortality in the later. Disappointingly, the evidence still shows that many healthcare professionals cannot use them and therefore cannot correctly instruct patients in their use, and that patients are still unable to maximise the benefits they could get from their inhalers because of poor technique and adherence. The following article discusses the issues and offers a simple approach and practical advice on teaching inhaler techniques. It concludes that maybe it is time for us to think differently to teach inhaler technique and use effectively.

scholarly journals Influence of microcirculatory disorders in patients with moderate chronic obstructive pulmonary disease and systemic arterial hypertension on acid-base and gas balance of blood.

2018 ◽  
Vol 96 (8) ◽  
pp. 729-734
Author(s):  
E. G. Zarubina ◽  
Y. E. Shaldybina ◽  
I. O. Prokhorenko
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Oxygen Consumption ◽  
Arterial Hypertension ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Acid Base ◽  
Obstructive Pulmonary Disease ◽  
Doppler Flowmetry ◽  
Systemic Arterial Hypertension ◽  
Microcirculatory Disorders

Material and methods. The clinical study involved 240patients (228 men and 12 women) aged 40 to 55, they were divided into 3 groups based on the duration of the disease. Patients of the first group suffered COPD disease up to 5 years, in the second group it was up to 10 years and in the third group it was more than 10 years. The degree of disturbance of microcirculation processes was investigated using laser Doppler flowmetry at the multifunction laser diagnostic complex “LAKK-M” (Russia, 2011). The following parameters were evaluated: the average perfusion value, saturation of mixed (capillary) blood, saturation of arterial blood, relative volume of the erythrocyte fraction in the skin of the middle fingertip, the index ofperfusion oxygen saturation in the microcirculation, the index of specific oxygen consumption in the tissue. The following parameters were also calculated: the efficiency of oxygen exchange, the fluorescence indicator of oxygen consumption; analysis of the frequency spectrum in the zone of myogenic, neurogenic and respiratory fluctuations of the blood flow. Results. As part of the study it was found that the increase in the prevalence of hypertension is increased in patients with COPD, depending on the duration of the disease: 2.5 times in patients of the 2nd group and 3.7 times in patients of the 3rd group compared with the patients of the 1st group. Based on the analysis of laser Doppler flowmetry data, the microcirculation index significantly changes in patients with COPD and AH in comparison with patients with isolated COPD by 5.7% (p <0.05) in the 1st group, by 11.8% (p <0.01) and 23.5% (p<0.001) in 2 and 3rd groups, respectively. Conclusion. The role of microcirculatory disorders was established in patients with comorbid pathology in the development of disorders in the gas composition parameters and acid-base balance of blood in patients with chronic obstructive pulmonary disease and systemic arterial hypertension, as well as the relationship between the duration of the anamnesis of comorbid pathology and the severity of the revealed disorders.

scholarly journals THE ROLE OF THE KIDNEYS IN THE REGULATION OF THE ACID – BASE BALANCE OF THE BLOOD IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

2021 ◽  
Vol 74 (2) ◽  
pp. 288-290
Author(s):  
Oksana V. Veremiienko ◽  
Tatyana S. Ospanova ◽  
Zhanna D. Semydotska
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Acid Base Balance ◽  
Acid Base ◽  
Obstructive Pulmonary Disease ◽  
Excretory Function ◽  
Base Balance ◽  
Group B ◽  
Renal Excretory Function

The aim: To study the regulation of acid-base balance and blood acid – renal excretory function in patients with COPD. Materials and methods: We examined 82 people, suggests that even during the most severe stages of COPD. Group 1 included 56 patients with COPD, group C. The average age was 60.54 + 2.04 years old, including 24 men and 32 women. The second group included 16 patients with COPD, group B, whose average age was 55.37 + 3.21 years old, including 7 men and 9 women. The third group included 10 healthy individuals, with an average age of 34.30 + 2.21 years, including 6 men and 4 women. Respiration function was evaluated on the basis of the forced expiratory curve recorded on a Spirolab II MIR S / N computer spirograph. The following indicators were evaluated: forced vital capacity (FVC), forced expiratory volume (FEV1) and FEV1 / FVC ratio. Results: For all patients with COPD there is a characteristic presence of acidosis (pH in patients with COPD group B – 7,34 ± 0,01, in patients with COPD group C – 7,31 ± 0,07). For patients with COPD group C there are pronounced respiratory disorders (pCO2 – 48,25 + 1,14 mm Hg, p02 – 28.07 +1.37 mm Hg). For patients with COPD group B characteristic metabolic disorders (BE--3,71 + 0,57), which increase as the disease progresses. For patients with COPD group C this figure is equal to 7.62 + 0.49. Thus, the analysis of indicators indicates the presence for all patients of mixed (respiratory and metabolic) acidosis, which increases as the chronic obstructive pulmonary disease progresses. Conclusions: There is activation of acid – renal excretory function and the inclusion of renal mechanisms in the regulation of acid-base balance.

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