Analysis of Bronchoscopy on Acute Exacerbation of Pulmonary Emphysema Chronic Obstructive Pulmonary Disease Using CT Chest Imaging

2019 ◽  
Vol 9 (8) ◽  
pp. 1753-1759
Author(s):  
Yalan Lin ◽  
Yunfeng Chen ◽  
Weisen Yu ◽  
Weijing Wu ◽  
Yuxia Du ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Ct Images ◽  
Chest Ct ◽  
Control Group ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Before And After ◽  
Experimental Group

Purpose: To understand the role of bronchoscopy in the treatment of chest CT images for patients with acute exacerbation of emphysema phenotype chronic obstructive pulmonary disease (COPD). Methods: 89 cases with chest CT images suggesting acute exacerbation of emphysema phenotype COPD were included and divided into the experimental group and the control group according to whether underwent bronchoscopy. Arterial blood gas indexes (pH value, PaO2, PaCO2), total glucocorticoid usage, length of stay, serum inflammatory factors (TNF-α, IL-6, IL-10) before and after treatment were compared between the two groups. Results: The hospitalization time of the experimental group was significantly shorter than that of the control group (11.88 ± 8.61 d vs. 16.50 ± 12.15 d, P = 0 045); the total use of methylprednisolone test group was 213.66 ± 32.07mg, and the control group was 250.83 ± 102.55 mg. The difference between the two groups was statistically significant (P = 0 028). The trend of repeated analysis of variance (F = 12 11,P = 0 001) were statistically significant. PaCO2 significantly decreased before and after the test in the experimental group (49.40 14.85 mmhg vs. 43.30 12.48 mmhg, P = 0.000). Plasma TNF-α and IL-6 decreased and IL-10 increased before and after the test. TNF-α and IL-6 increased and IL-10 decreased before and after the control group test, and the changes and trends of TNF-α, IL-6 and IL-10 before and after the two groups were statistically different (P = 0.000). These symptoms can be analyzed using CT imaging. Conclusion: In patients with acute exacerbation of emphysema phenotype COPD who are initially ineffective, bronchoscopy, alveolar lavage, and anti-contamination brush sampling guide anti-infective treatment can improve patient ventilation, and reduce glucocorticoid consumption.

scholarly journals Clearing heat and resolving phlegm for acute exacerbation of chronic obstructive pulmonary disease with the syndrome of phlegm-heat obstruction of the lung

2020 ◽  
Vol 48 (8) ◽  
pp. 030006052094550
Author(s):  
Jia Yang ◽  
Junchao Yang
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Large Scale ◽  
Control Group ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Protein Levels ◽  
Reactive Protein

Objective This study aimed to evaluate the effect of clearing heat and resolving phlegm for acute exacerbation of chronic obstructive pulmonary disease with the syndrome of phlegm-heat obstruction of the lung. Methods This was a real-world retrospective cohort study of inpatients at our institution from 1 January 2015 to 31 December 2017. The patients were divided into two groups according to whether they received oral traditional Chinese medicine (TCM) for clearing heat and resolving phlegm or routine treatment (controls). Efficacy and safety indicators were analyzed. Propensity score matching was used to control for confounding factors. Results Among 488 patients, 164 (82 pairs) were successfully matched. The changes in neutrophils (%) and C-reactive protein levels were more significant in the TCM group than in the control group. The duration of fever was significantly shorter in the TCM group than in the control group. Conclusions The therapy of clearing heat and resolving phlegm might effectively control the inflammatory reaction of acute exacerbation of chronic obstructive pulmonary disease in patients with the syndrome of phlegm-heat obstruction of the lung, especially for those with fever. Nevertheless, large-scale and prospective studies are required to provide a higher quality of evidence.

scholarly journals Evaluation of outcomes of medication therapy management (MTM) services for patients with chronic obstructive pulmonary disease (COPD)

2021 ◽  
Vol 37 (7) ◽  
Author(s):  
Mingyue Liu ◽  
Jiayun Liu ◽  
Zhihui Geng ◽  
Shuang Bai
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Medication Therapy Management ◽  
Control Group ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Therapy Management ◽  
Medication Therapy ◽  
Copd Patients ◽  
Experimental Group

Objectives: To evaluate the outcomes of clinical pharmacist-led medication therapy management (MTM) services for patients with chronic obstructive pulmonary disease (COPD). Methods: Two hundred COPD patients admitted by the Department of Respiratory and Critical Care Medicine of Baoding No.1 Central Hospital during January 2019 and December 2020 were randomly assigned to a control group (n =100) and an experimental group (n =100). Patients in the control group received conventional treatment, while those in the experimental group were provided with MTM services based on the conventional treatment for comparative analysis of outcome measures, including use of antibacterials during hospital stay, length of stay (LoS), costs of hospitalization (CoH), cases of adverse drug reactions (ADRs), and medication adherence (MA) and COPD assessment test (CAT) score one and six months after discharge. Results: Compared with the control group, the experimental group had reduced use of antibacterials during hospital stay, LoS, CoH, and ADR rate (P <0.05). After discharge, patients in both groups showed remarkable improvements in MA and CAT scores in comparison with their performances upon admission, and the experimental group exhibited better MA and higher CAT score than the control group, with the differences indicating statistical significance (P <0.05). Conclusion: MTM designed for COPD patients can improve pharmacist-led service quality and clinical outcomes of COPD. doi: https://doi.org/10.12669/pjms.37.7.4518 How to cite this:Liu M, Liu J, Geng Z, Bai S. Evaluation of outcomes of medication therapy management (MTM) services for patients with chronic obstructive pulmonary disease (COPD). Pak J Med Sci. 2021;37(7):---------. doi: https://doi.org/10.12669/pjms.37.7.4518 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Optimizing inhalation therapy in the aspect of peak inhalation flow rate in patients with chronic obstructive pulmonary disease or asthma

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jian-lan Hua ◽  
Xiao-fen Ye ◽  
Chun-ling Du ◽  
Ning Xie ◽  
Jie-qing Zhang ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Flow Rate ◽  
Inhalation Therapy ◽  
Chronic Obstructive ◽  
Control Analysis ◽  
Inhaler Technique ◽  
Obstructive Pulmonary Disease ◽  
Before And After

Abstract Background Pressurized metered dose inhalers (pMDIs) and dry powder inhalers (DPIs) are commonly used drug-delivering devices for patients with chronic airway diseases. Appropriate peak inhalation flow rate (PIFR) and inhaler technique is essential for effective therapy. We aimed at optimizing inhalation therapy through the analysis of PIFRs in patients with chronic obstructive pulmonary disease (COPD) or asthma as well as the effect of technique training using In-Check DIAL® to help patients to achieve their optimal inspiratory flow rates. Methods The study continuously enrolled patients who were diagnosed as COPD or asthma from respiratory clinics. PIFRs were described and analyzed between the newly-diagnosed and follow-up patients, and the stable and acute exacerbation patients, respectively. Every participant was trained inhaler technique using In-Check DIAL®. PIFRs before and after training was compared by self-control analysis. Results Among a total of 209 patients, the average age was 56.9 years. For DPIs users, 10.8% patients had a PIFR < 30 L/min and 44.1% patients had a PIFR ≥ 60 L/min before technique training. After technique training, scarcely patient (1.5%) had a PIFR < 30 L/min, and 60.5% patients had a PIFR ≥ 60 L/min. The patient’s average PIFR increased by 5.6L/min after training. The increase in PIFR before and after training was significant (p < 0.001) for most patients, but no significant variation was found in patients with acute exacerbation (p = 0.822). Conclusions A considerable number of patients with COPD or asthma were not able to achieve the minimum or optimal PIFR for DPIs. Inhaler training can increase patients’ PIFRs and improve their ability to use DPIs. Trail registration The study has registered in chictr.org.cn (ChiCTR1900024707) and been approved by the Ethics Committee of Zhongshan Hospital of Fudan University (B2019-142).

scholarly journals Virtual Reality Technology Combined with Comprehensive Pulmonary Rehabilitation on Patients with Stable Chronic Obstructive Pulmonary Disease

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Xiangmei Xie ◽  
Jie Fan ◽  
Huihong Chen ◽  
Ling Zhu ◽  
Ting Wan ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Virtual Reality ◽  
Pulmonary Disease ◽  
Technical Support ◽  
Control Group ◽  
Chronic Obstructive ◽  
Virtual Reality Technology ◽  
Obstructive Pulmonary Disease ◽  
Breathing Exercises ◽  
Experimental Group

With the popularization of medical knowledge and the development of medical technology, people pay more and more attention to COPD. This paper mainly studies the effect of virtual reality technology combined with comprehensive lung rehabilitation on patients with stable chronic obstructive pulmonary disease. 60 patients with stable chronic obstructive pulmonary disease were selected to collect their general information, such as name, gender, and age. They were divided into the experimental group and control group, 30 patients in each group. The experimental group was treated with virtual reality technology combined with lung rehabilitation, while the control group was treated with conventional rehabilitation. Patients in both groups needed medication and participated in a 30-minute disease description activity once a week. In addition, patients in the control group should walk for 20 minutes every day to monitor muscle fatigue. Breathing exercises are also carried out regularly. Patients are instructed to use their lips and abdomen for 5 minutes each time. The respiratory rate was 7 beats per minute. In addition to the routine training of the control group, the experimental group will also train the simulated bicycle for 20 minutes, which will be automatically saved on the computer after the training. After the experiment, the muscle function and motor ability of the two groups were evaluated, and the results were statistically analyzed. The total self-efficacy scores of patients before and after telemedicine technical support increased significantly (2.15 ± 0.21 before telemedicine technical support, 2.39 ± 0.20 after telemedicine technical support), and the difference was statistically significant ( P < 0.05 ). The results show that the application of virtual reality technology can improve the rehabilitation belief of patients and strengthen the training effect.

scholarly journals Clinical efficacy of acupoint application of Chinese herbal medicine to prevent acute exacerbation of stable chronic obstructive pulmonary disease: A study protocol for a randomized placebo-controlled trial

2019 ◽  
Author(s):  
Zhang Chuantao ◽  
Yang Hongjing ◽  
Gan Wenfan ◽  
Xie Xiaohong ◽  
Gao Peiyang ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Clinical Trial ◽  
Acute Exacerbation ◽  
Controlled Trial ◽  
Control Group ◽  
Chronic Obstructive ◽  
Efficacy And Safety ◽  
Obstructive Pulmonary Disease ◽  
Chinese Herbal ◽  
Experimental Group

Abstract Background: Chronic obstructive pulmonary disease (COPD) is a major public health problem that severely affects the quality of life of patients and may even endanger their lives. The key to prevent the progression of COPD is active treatment during the stable phase that prevents and reduces acute exacerbation of COPD. Although modern medicine has achieved significant results in relieving the clinical manifestations of COPD, it is difficult to prevent its progression and acute exacerbation entirely. As one of the classic aspects of acupuncture and moxibustion therapy, acupoint application of Chinese herbal medicine (CHM) can improve the clinical efficacy of Western medicine in treating COPD. To date, however,there is no high-quality clinical trial to assess the effectiveness of CHM acupoint application directly in preventing acute exacerbation of stable COPD.Thus, we designed this randomized placebo-controlled clinical trial to evaluate the long-term efficacy and safety of CHM acupoint application in preventing the acute exacerbation of stable COPD.Methods: The study is a randomized, double-blind, placebo-controlled trial, in which 200 stable COPD patients will be randomly and equally divided into the experimental group or control group. Both groups will undergo standard Western medicine treatment; however, the patients in the experimental group will be also treated with CHM acupoint application, while the control group will be given placebo acupoint application. The duration of the treatment will be 1 month and a follow-up for 11 months. The primary outcome will be the number of acute exacerbation episodes of COPD, and the secondary outcomes will include the lung function, St George's Respiratory Questionnaire, COPD Assessment Test, and 6-Minute Walk Test. A safety assessment will also be performed during the trial.Discussion: The aim of this study is to evaluate the efficacy and safety of CHM acupoint application in preventing acute exacerbation of stable COPD. Our study will provide sound evidence to support the evidence-based medicine of CHM acupoint application as an additional measure in the prevention of acute exacerbation of stable COPD.

scholarly journals Predictive Value of Novel Inflammation-Based Biomarkers for Pulmonary Hypertension in the Acute Exacerbation of Chronic Obstructive Pulmonary Disease

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Huanhuan Zuo ◽  
Xiaochen Xie ◽  
Jiahuan Peng ◽  
Lixin Wang ◽  
Rong Zhu
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Hypertension ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Univariate Analysis ◽  
Systolic Pressure ◽  
Control Group ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Lymphocyte Ratio

Recently, there has been an increasing interest in the potential clinical use of several inflammatory indexes, namely, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic-immune-inflammation index (SII). This study aimed at assessing whether these markers could be early indicators of pulmonary hypertension (PH) in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). A total of 185 patients were enrolled in our retrospective study from January 2017 to January 2019. Receiver operating characteristic curve (ROC) and area under the curve (AUC) were used to evaluate the clinical significance of these biomarkers to predict PH in patients with AECOPD. According to the diagnostic criterion for PH by Doppler echocardiography, the patients were stratified into two groups. The study group consisted of 101 patients complicated with PH, and the control group had 84 patients. The NLR, PLR, and SII values of the PH group were significantly higher than those of the AECOPD one (p<0.05). The blood biomarker levels were positively correlated with NT-proBNP levels, while they had no significant correlation with the estimated pulmonary arterial systolic pressure (PASP) other than PLR. NLR, PLR, and SII values were all associated with PH (p<0.05) in the univariate analysis, but not in the multivariate analysis. The AUC of NLR used for predicting PH was 0.701 and was higher than PLR and SII. Using 4.659 as the cut-off value of NLR, the sensitivity was 81.2%, and the specificity was 59.5%. In conclusion, these simple markers may be useful in the prediction of PH in patients with AECOPD.

scholarly journals Application of Artificial Intelligence in Emergency Nursing of Patients with Chronic Obstructive Pulmonary Disease

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Lingzhi Hong ◽  
Xufang Cheng ◽  
Deming Zheng
Keyword(s):  
Quality Of Life ◽  
Artificial Intelligence ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Controlled Trial ◽  
Control Group ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Experimental Group

The research achievements of artificial intelligence technology in the development of chronic obstructive pulmonary disease were explored, and the advantages and problems encountered in the development of intelligent nursing were analyzed. This paper presents the application of artificial intelligence in the emergency care of patients with chronic obstructive pulmonary disease. The method included 447 COPD patients in a randomized controlled trial to observe the improvement of quality of life at 4 and 12 months after artificial intelligence medical intervention. A prospective randomized controlled trial included 101 patients with COPD who underwent a 9-month web-based knowledge exercise on the prevention of acute exacerbation of COPD through artificial intelligence medicine and were randomly divided into two groups: the experimental group and the control group. The results show that, in the experimental group and the control group, after 4 months, the quality of life does not change; after 12 months, compared with controls, the quality of life and emotional and psychological conditions have improved obviously. 29 patients who participated in the experiment and were randomly divided into the experimental group and the control group showed satisfactory results. COPD hospitalized rate and length of hospital stay were decreased in the experimental group than in the control group. For single-factor analysis, artificial intelligence medical intervention has not achieved significant significance, and the experimental results have preliminarily confirmed the effectiveness of artificial intelligence medical treatment.

scholarly journals The Effects of Safflower Yellow on Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Randomized, Controlled Clinical Trial

2019 ◽  
Vol 2019 ◽  
pp. 1-14 ◽  
Author(s):  
Xiao-jin Li ◽  
Yan Kang ◽  
Ru-rong Wang ◽  
Xue-lian Liao ◽  
Xiao-feng Ou ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Hospital Stay ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Average Length ◽  
Intervention Group ◽  
Control Group ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Randomized Controlled

Objectives. To evaluate the efficacy of safflower yellow in the acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods. In a prospective, randomized, controlled trial, 127 patients who met the inclusion criteria were enrolled and were randomly divided into two groups. The control group included 64 patients treated according to the global strategy for diagnosis, management, and prevention of COPD (www.goldcopd.org, updated 2011). The intervention group included 63 patients who received intravenous infusions of safflower yellow (100 mg of safflower yellow dissolved in 250 ml 0.9% saline) once daily for 14 consecutive days in addition to standard diagnosis and treatment. The difference in the average length of the hospital stay between the two groups of patients was determined. The follow-up period was 28 days; the differences in symptoms, clinical indicators, and 28-day mortality in the two groups were compared. Statistical analysis was conducted using SPSS 22.0 software to determine whether there were statistically significant differences (P <0.05) between groups. Results. There were no statistically significant differences between the intervention group and the control group in changes in secondary indicators. There were no statistically significant differences in the 28-day mortality or in the survival curves of the two groups (P=0.496 and P=0.075, respectively). Safflower yellow treatment of AECOPD may relieve the patient’s clinical symptoms, such as dyspnoea, shorten the average length of hospital stay (P=0.006, respectively), and decrease the duration of mechanical ventilation. Conclusion. Safflower yellow in the treatment of AECOPD has a degree of clinical value. This trial is registered under the identifier ChiCTR-IPR-17014176.

scholarly journals APPLICATION OF EXERCISE COMBINED WITH LUNG REHABILITATION IN RESPIRATORY DISEASE

2022 ◽  
Vol 28 (1) ◽  
pp. 17-19
Author(s):  
Guangheng Wang ◽  
Yuqi Cai
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Educational Interventions ◽  
Control Group ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Breathing Training ◽  
Group 2 ◽  
Experimental Group ◽  
Group 1

ABSTRACT Introduction: Chronic obstructive pulmonary disease (COPD) is a respiratory disease characterized by incomplete reversibility of airflow obstruction and persistent respiratory symptoms. Objective: To explore the therapeutic effect of physical exercise on patients with chronic obstructive pulmonary disease in pulmonary rehabilitation. Methods: Forty-eight experimental subjects were divided into control group, experimental group 1, and experimental group 2 for research. The control group received normal medical-related treatment without any other means of intervention. In addition to normal medical-related treatment, experimental group 1 received breathing training and educational interventions and experimental group 2 received exercise, breathing training and educational interventions. Results: The vital capacity of female subjects before and during the experiment ranged from 2.23±0.01 to 2.26±0.04, the FVC ranged from 2.00±0.02 to 2.01±0.03, the FEV1 ranged from 1.03±0.01 to 1.03±0.01,the FEV1% ranged from 55.50±1.29 to 55.25±1.71,the FEV1/FVC ranged from 51.44±0.24 to 50.84±1.00, andthe heart rate ranges from 65.00±0.82 to 65.50±1.29. Conclusions: Exercise training can increase the exercise tolerance of patients with COPD, relieve dyspnea, and improve the quality of life. Level of evidence II; Therapeutic studies - investigation of treatment results.

scholarly journals Effect of Inspiratory Muscle Training on Anxiety and Depression in Patient with COPD that Received Pursed Lip Breathing ABSTRACT

2021 ◽  
Vol 9 (2) ◽  
pp. 19-26
Author(s):  
Yeanita ◽  
Rahmi Isma AP
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Depression Scale ◽  
Anxiety And Depression ◽  
Control Group ◽  
Chronic Obstructive ◽  
Hospital Anxiety ◽  
Muscle Training ◽  
Obstructive Pulmonary Disease ◽  
Experimental Group

ABSTRACTIntroduction: The presence of anxiety and depression in patients with Chronic Obstructive Pulmonary Disease (COPD) is often associated with greater disability, higher rates of exacerbations, increasedhospitalization and mortality. Many types of breathing exercises, such as Pursed Lips Breathing (PLB), Diaphragmatic Breathing (DBE), Respiratory Muscle Training (RMT), have been reported positivephysiological effects to reduces breathlessness, anxiety and depression in patients with COPD. This study aims to determine the effect in anxiety and depression after intervention of Inspiratory MuscleTraining (IMT) in COPD patients that received PLB.Methods: An experimental pre and post randomly study design, in August – September 2019. Control group and experimental group each performed PLB exercises while the experimental group got additionalIMT. To evaluate anxiety and depression status, Hospital Anxiety and Depression Scale (HADS) was used.Results: Twenty subjects with COPD were recruited, no significant differences of HADS score between both groups. After 6 weeks of intervention, the HADS score in each group decreased significantly, withdelta of HADS score in experimental group was greater than the control group (p<0.05).Conclusion: Improvement of HADS scores after additional IMT was better than PLB only in COPD patients.Keywords: chronic obstructive pulmonary disease; hospital anxiety and depression scale; inspiratory muscle training; pursed lips breathing.

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