Domiciliary Nebuliser Therapy — A Valuable Option in Chronic Asthma and Chronic Obstructive Pulmonary Disease?

1998 ◽  
Vol 43 (2) ◽  
pp. 48-51 ◽  
Author(s):  
D.J. Godden ◽  
A. Robertson ◽  
N. Currie ◽  
J.S. Legge ◽  
J.A.R. Friend ◽  
...  

Domiciliary nebulisers are in widespread use for patients who have severe chronic airways disease, both asthma and chronic obstructive pulmonary disease (COPD). We report a study of the use of domiciliary nebulisers designed to assess practical problems and the value of such therapy in preventing hospital admissions. A total of 405 patients underwent a structured interview at home and their case records were reviewed. Technical performance of the nebuliser compressors was assessed The mean (SD) age of those interviewed was 64.5 (12) years. 185 patients had a physician diagnosis of asthma, and 208 had COPD. 87% patients used their nebuliser at least once daily. Side effects, reported by 54%, were related to frequency of use and commoner in younger patients. 29 subjects (7%) died within 2 years of receiving their nebuliser. Among the survivors, the 2 year periods before and after supply of the nebuliser were compared The percentage of patients requiring hospital admission for exacerbations of lung disease fell from 56% to 46% (p<0.01) but the number and duration of admissions was unchanged Those whose admission duration increased had more severely impaired spirometry when the nebuliser was supplied and had lower activity scores and higher breathlessness scores at the time of interview indicating more severe disease. Approximately half of the compressors were malfunctioning and patients' understanding of the principles of nebuliser treatment was poor. The provision of domiciliary nebuliser can influence hospital admission inpatients with obstructive airways disease. There is also a need for improved patient education and for technical support which may require the development of a nurse-run nebuliser service.

2020 ◽  
Vol 90 (3) ◽  
Author(s):  
Idir Ramdani ◽  
Karen A. Pescatore ◽  
Belaid Bouazza

Chronic obstructive pulmonary disease (COPD) is a progressive chronic inflammatory disease and the third cause of death worldwide in 2016. COPD epidemiology is well documented in high-income countries where the disease is well managed. However, the disease is neglected in low-income countries and there is lack of data. Our study aims to identify COPD patients’ characteristics and hospital admission causes, and to determine disease etiologies and associated factors. A retrospective study was conducted in COPD Algerian patients using medical record data collected from January 2007 to May 2017 at the pulmonology department of the Belloua Hospital of Tizi-Ouzou city. Out of 133 hospital admissions for COPD during the study period, only 120 records were found and analyzed. Most of the admitted patients were men (96%) and the mean age was 74.29±9.56 years. Among them, 78.7% were in the GOLD stage III or IV and 9 deaths (7.5%) were recorded during the study period. Interestingly, disease severity is associated with increasing age of the patients and mortality (p=0.01 and p=0.02, respectively). Risk factors include cigarette smoking (93%), history of medical conditions (36.66%) with the most prevalent conditions being emphysema (38.63%) and asthma (27.27%), the cold season (47%), and occupational exposures (58%). Most of the admissions (64.16%) were due to acute dyspnea and 21.66 % to respiratory infections, however, 34.16 % of patients were readmitted at least one time. Comorbidities were observed in 57.5% of the patients, including cardiovascular diseases (63.76%) and diabetes (18.84%). These results show that COPD severity is associated with age and mortality. Better understanding of the COPD etiologies and the causes of hospital admission will lead to more effective management of the disease.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yanji Qu ◽  
Wangjian Zhang ◽  
Bo Ye ◽  
Samantha Penta ◽  
Guanghui Dong ◽  
...  

Abstract Background Chronic obstructive pulmonary disease (COPD) is the third-leading cause of death worldwide with continuous rise. Limited studies indicate that COPD was associated with major storms and related power outages (PO). However, significant gaps remain in understanding what PO’s role is on the pathway of major storms-COPD. This study aimed to examine how PO mediates the major storms-COPD associations. Methods In this time-series study, we extracted all hospital admissions with COPD as the principal diagnosis in New York, 2001–2013. Using distributed lag nonlinear models, the hospitalization rate during major storms and PO was compared to non-major storms and non-PO periods to determine the risk ratios (RRs) for COPD at each of 0–6 lag days respectively after controlling for time-varying confounders and concentration of fine particulate matter (PM2.5). We then used Granger mediation analysis for time series to assess the mediation effect of PO on the major storms-COPD associations. Results The RRs of COPD hospitalization following major storms, which mainly included flooding, thunder, hurricane, snow, ice, and wind, were 1.23 to 1.49 across lag 0–6 days. The risk was strongest at lag3 and lasted significantly for 4 days. Compared with non-outage periods, the PO period was associated with 1.23 to 1.61 higher risk of COPD admissions across lag 0–6 days. The risk lasted significantly for 2 days and was strongest at lag2. Snow, hurricane and wind were the top three contributors of PO among the major storms. PO mediated as much as 49.6 to 65.0% of the major storms-COPD associations. Conclusions Both major storms and PO were associated with increased hospital admission of COPD. PO mediated almost half of the major storms-COPD hospitalization associations. Preparation of surrogate electric system before major storms is essential to reduce major storms-COPD hospitalization.


2021 ◽  
Vol 10 (7) ◽  
pp. 1529
Author(s):  
Domingo Orozco-Beltrán ◽  
Juan Manuel Arriero-Marin ◽  
Concepción Carratalá-Munuera ◽  
Juan J. Soler-Cataluña ◽  
Adriana Lopez-Pineda ◽  
...  

The prevalence of chronic obstructive pulmonary disease (COPD) is rising faster in women in some countries. An observational time trends study was performed to assess the evolution of hospital admissions for COPD in men and women in Spain from 1998 to 2018. ICD-9 diagnostic codes (490–492, 496) from the minimum basic data set of hospital discharges were used. Age-standardised admission rates were calculated using the European Standard Population. Joinpoint regression models were fitted to estimate the annual percent change (APC). In 2018, the age-standardised admission rate per 100,000 population/year for COPD was five times higher in men (384.8, 95% CI: 381.7, 387.9) than in women (78.6, 95% CI: 77.4, 79.9). The average annual percent change (AAPC) was negative over the whole study period in men (−1.7%/year, 95% CI: −3.1, −0.2) but positive from 2010 to 2018 (1.1%/year, 95% CI: −0.8, 2.9). In women, the APC was −6.0% (95%CI: −7.1, −4.9) from 1998 to 2010, but the trend reversed direction in the 2010–2018 period (7.8%/year, 95% CI: 5.5, 10.2). Thus, admission rates for COPD decreased from 1998 to 2010 in both men and women but started rising again until 2018, modestly in men and sharply in women.


2014 ◽  
Vol 21 (1) ◽  
pp. 47-52
Author(s):  
Cecília Rossatto Facco ◽  
Juliana Corrêa Soares ◽  
Carlos Bolli Mota ◽  
Maria Elaine Trevisan

The objective of this study was to evaluate the functionality of gait and cardiorespiratory parameters in individuals with chronic obstructive pulmonary disease (COPD), before and after a walk test, in order to allow the development of strategies, aimed at maintaining autonomy and preservation of independence. In this study, were included individuals with COPD, aged between 50 to 80 years, and excluded those with orthopedic, neurological and cardiac problems, or any condition that would prevent the assessments proposed in this study. The variables measured were:1st peak force, mid peak low and 2nd peak force, time of 1st double support, the swing moment and 2nd double support; single support time, stride length and stride, speed and time gait cycle, heart rate, oxygen saturation and dyspnea/tiredness score, pre and post-test. The sample consisted of 14 individuals (8 females and 6 males), mean age 65.21±9.42 years. In the post-test patients had greater sensation of dyspnea / fatigue, increased speed and reduced time of the gait cycle, increase the 1st peak force and reduction of the mid peak low, reduction the time the 1st double support and the time of the 1st peak force. The physical effort had influenced the gait pattern and cardiorespiratory parameters in this group of individuals with COPD.


2019 ◽  
Vol 69 (1) ◽  
pp. 149-157 ◽  
Author(s):  
Sebastian Rutkowski ◽  
Anna Rutkowska ◽  
Dariusz Jastrzębski ◽  
Henryk Racheniuk ◽  
Witold Pawełczyk ◽  
...  

Abstract The aim of the study was to evaluate the effects of rehabilitation in patients with chronic obstructive pulmonary disease (COPD) using the Kinect system during stationary rehabilitation. The study included 68 patients with COPD (35 men, 33 women, mean age 61.3 ± 3.7). The subjects were randomly assigned to one of the two experimental groups described below. Group I included 34 patients – non‐participants in Kinect training. Group II included 34 patients – participants in Kinect training. In all patients before and after rehabilitation physical fitness was assessed using the Senior Fitness Test (SFT). The Xbox 360 and Kinect motion sensor were used to carry out virtual reality training. In group I, statistically significant improvements in SFT performance were observed. Patients in group II also showed statistically significant improvement in physical fitness in all attempts of the SFT. Virtual rehabilitation training in patients with COPD seems to be a practical and beneficial intervention capable of enhancing mobility and physical fitness.


2019 ◽  
Vol 7 (01) ◽  
pp. 28
Author(s):  
Nury Nusdwinuringtyas ◽  
Siti Chandra Widjanantie

Introduction: Chronic Obstructive Pulmonary Disease (COPD) was characteristic by the inflammatory process in the airway which causes air trapping and hyperinflation, then followed by decreasing the respiratory muscle strength. Breathing training using the positive expiratory pressure (PEP) increasing respiratory muscle strength.Methods: A case presentation of a male, age was 60 years old diagnosed as COPD by The Global Initiative for Chronic Obstructive Lung Disease (GOLD) grade 4 group D, and Chronic Heart Failure (CHF) grade II, with complication of excessive phlegm, underweight, and weakness of respiratory muscle, have PEP for 8 weeks.Results: Spirometry evaluation before and after eight week of PEP have found; FEV1 22.12 and 22.42%, FVC 34.24 and 56%, FEV1/FVC 76.8 and 64%. Respiratory muscle strength before and after PEP showed the Muscle Inspiratory Pressure (MIP) 46 and 71 cmH2O, Muscle Expiratory Pressure (MEP) 48 and 104 cmH2O.The values of Six Minute Walk Test (6MWT) evaluation by BORG modified scale before and after PEP were 11 and 13 ( efforts), 2 and 3 (dyspnea), 0 and 1 (Leg Fatigue). The six-minute walking distance (6MWD) before and after PED were 170 and 190 m, equation reference with Nury’s formula showed percentage prediction before and after PEP respectively 29.2 and 32%, VO2Max; 4.96 and 6L, METs; 1.41 and 1.7. The St GeorgeRespiratory Questionnaire (SGRQ) before and after PEP were 20.6 and 49.5% (symptom), 86.6 and 45.1% (activity), 45.5 and 18.4% (impact) and 53.6 and 42% for total.Conclusion: Positive airway pressure exercise had beneficial effect on reducing air-trapping process in COPD and increasing the respiratory muscle strength for both expiratory and inspiratory muscle strength.Keywords: Chronic obstructive pulmonary disease, positive expiratory pressure device, respiratory muscle strength, six minutes walking distance


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