scholarly journals IMPROVEMENT OF LUNG FUNCTION WITH COADMINISTERED FORMOTEROL AND TIOTROPIUM, REGARDLESS OF SMOKING STATUS IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

CHEST Journal ◽  
2008 ◽  
Vol 134 (4) ◽  
pp. 103P ◽  
Author(s):  
Donald P. Tashkin ◽  
James L. Pearle ◽  
Santosh Varghese
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Lung Function ◽  
Pulmonary Disease ◽  
Smoking Status ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease

scholarly journals Impact of smoking status on the efficacy of inhaled corticosteroids in chronic obstructive pulmonary disease: a systematic review

BMJ Open ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. e037509
Author(s):  
Kimberley Sonnex ◽  
Hanna Alleemudder ◽  
Roger Knaggs
Keyword(s):  
Systematic Review ◽  
Chronic Obstructive Pulmonary Disease ◽  
Lung Function ◽  
Pulmonary Disease ◽  
Inhaled Corticosteroids ◽  
Smoking Status ◽  
Steroid Resistance ◽  
Cochrane Library ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease

ObjectivesInhaled corticosteroids (ICS) reduce exacerbation rates and the decline in lung function in people with chronic obstructive pulmonary disease (COPD). There is evidence that smoking causes ‘steroid resistance’ and thus reduces the effect of ICS. This systematic review aimed to investigate the effect of smoking on efficacy of ICS in COPD in terms of lung function and exacerbation rates.DesignSystematic review.Data sourcesAn electronic database search of PubMed, Ovid MEDLINE, Ovid Embase and Cochrane Library (January 2000 to January 2020).Eligibility criteriaFully published randomised controlled trials (RCTs), in the English language, evaluating the use of ICS in COPD adults that stratified the participants by smoking status. Trials that included participants with asthma, lung cancer and pneumonia were excluded. The primary outcome measures were changes in lung function and yearly exacerbation rates.Data extraction and synthesisTwo independent reviewers extracted data and assessed risk of bias using the Cochrane Collaboration’s tool.ResultsSeven studies were identified. Four trials (17 892 participants) recorded change in forced expiratory volume in one second (FEV1) from baseline to up to 30 months after starting treatment. Heavier smokers (>36 pack years) using ICS had a greater decline in FEV1that ranged from −22 mL to −75 mL in comparison to lighter smokers. Smokers using ICS had mixed results in FEV1change: −8 mL to +77 mL in comparison to ex-smokers. Four trials (21 270 participants) recorded difference in COPD exacerbation rates at 52 weeks. The rate ratios favoured more exacerbations in ICS users who were current or heavier smokers than those who were ex-smokers or lighter smokers (0.81 to 0.99 vs 0.92 to 1.29).ConclusionsIn COPD, heavier or current smokers do not gain the same benefit from ICS use on lung function and exacerbation rates as lighter or ex-smokers do, however effects may not be clinically important.PROSPERO registration numberCRD42019121833

Screening of High-risk Patients for Chronic Obstructive Pulmonary Disease in Primary Care: A Narrative Review (Preprint)

2020 ◽  
Author(s):  
Ponrathi Athilingam ◽  
Andrew Bugajski ◽  
Usha Menon
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Lung Function ◽  
Pulmonary Disease ◽  
Current Knowledge ◽  
Screening Tools ◽  
Chronic Obstructive ◽  
Early Screening ◽  
Obstructive Pulmonary Disease ◽  
Impaired Lung Function ◽  
Risk Patients

UNSTRUCTURED Chronic obstructive pulmonary disease (COPD) predominantly affects older adults, and claimed 3 million lives in 2016, making it the third leading cause of death worldwide. Over 35 million Americans aged 40 or older have lung function consistent with diagnosable COPD. COPD and cardiovascular disease (CVD) have a bidirectional relationship, in that one is a risk factor for developing the other. National and international consortiums recommend early screening of adults at risk of COPD, such as those with CVD. Recommended screening strategies include screening tools to assess symptoms, medical history, and handheld spirometry. Handheld spirometry has high diagnostic accuracy and if impaired lung function is indicated, these patients are referred for pulmonary function testing (PFT), the diagnostic gold standard for COPD. However, there is no clinical consensus for pulmonary screening in people with CVD. Current knowledge relating to the prevalence and incidence of CVD in people with COPD and the mechanisms that underlie their coexistence is key in combating the global burden of COPD.

scholarly journals Mechanisms of gas exchange response to lung volume reduction surgery in severe emphysema

2011 ◽  
Vol 110 (4) ◽  
pp. 1036-1045 ◽  
Author(s):  
George Cremona ◽  
Joan A. Barbara ◽  
Teresa Melgosa ◽  
Lorenzo Appendini ◽  
Josep Roca ◽  
...  
Keyword(s):  
Mechanical Properties ◽  
Chronic Obstructive Pulmonary Disease ◽  
Lung Function ◽  
Gas Exchange ◽  
Pulmonary Disease ◽  
Lung Volume ◽  
Chronic Obstructive ◽  
Lung Volume Reduction Surgery ◽  
Lung Volume Reduction ◽  
Obstructive Pulmonary Disease

Lung volume reduction surgery (LVRS) improves lung function, respiratory symptoms, and exercise tolerance in selected patients with chronic obstructive pulmonary disease, who have heterogeneous emphysema. However, the reported effects of LVRS on gas exchange are variable, even when lung function is improved. To clarify how LVRS affects gas exchange in chronic obstructive pulmonary disease, 23 patients were studied before LVRS, 14 of whom were again studied afterwards. We performed measurements of lung mechanics, pulmonary hemodynamics, and ventilation-perfusion (V̇a/Q̇) inequality using the multiple inert-gas elimination technique. LVRS improved arterial Po2 (PaO2) by a mean of 6 Torr ( P = 0.04), with no significant effect on arterial Pco2 (PaCO2), but with great variability in both. Lung mechanical properties improved considerably more than did gas exchange. Post-LVRS PaO2 depended mostly on its pre-LVRS value, whereas improvement in PaO2 was explained mostly by improved V̇a/Q̇ inequality, with lesser contributions from both increased ventilation and higher mixed venous Po2. However, no index of lung mechanical properties correlated with PaO2. Conversely, post-LVRS PaCO2 bore no relationship to its pre-LVRS value, whereas changes in PaCO2 were tightly related ( r2 = 0.96) to variables, reflecting decrease in static lung hyperinflation (intrinsic positive end-expiratory pressure and residual volume/total lung capacity) and increase in airflow potential (tidal volume and maximal inspiratory pressure), but not to V̇a/Q̇ distribution changes. Individual gas exchange responses to LVRS vary greatly, but can be explained by changes in combinations of determining variables that are different for oxygen and carbon dioxide.

Serum heavy metals and lung function in a chronic obstructive pulmonary disease cohort

2017 ◽  
Vol 9 (1) ◽  
pp. 30-35 ◽  
Author(s):  
Jeongwon Heo ◽  
Hyun Sun Park ◽  
Yoonki Hong ◽  
Jinkyeong Park ◽  
Seok-Ho Hong ◽  
...  
Keyword(s):  
Heavy Metals ◽  
Chronic Obstructive Pulmonary Disease ◽  
Lung Function ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease
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