Correlation of the Spirometric and Arterial Blood Gas Variables with Pulmonary Artery Systolic Pressure in Predicting Pulmonary Hypertension in Chronic Obstructive Pulmonary Disease Patients

2018 ◽  
Vol 4 (2) ◽  
pp. 170-175
Author(s):  
Vivekanand N. Waghmare ◽  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Hypertension ◽  
Pulmonary Artery ◽  
Systolic Pressure ◽  
Pulmonary Artery Systolic Pressure ◽  
Chronic Obstructive ◽  
Blood Gas ◽  
Obstructive Pulmonary Disease ◽  
Arterial Blood Gas ◽  
Arterial Blood

Effects of Sildenafil on spirometric pulmonary function parameters, pulmonary artery systolic pressure and BNP levels in patients with chronic obstructive pulmonary disease and erectile dysfunction

2021 ◽  
Vol 6 (4) ◽  
pp. 226-233
Author(s):  
Keski Hakan ◽  
Demirtunç Refik
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Erectile Dysfunction ◽  
Single Dose ◽  
Pulmonary Artery ◽  
Systolic Pressure ◽  
Pulmonary Artery Systolic Pressure ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Baseline Values

We aimed to investigate the effects of Sildenafil on pulmonary artery systolic pressure (PASP) as well as forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) and serum brain-type natriuretic peptide (BNP) levels in stable chronic obstructive pulmonary disease (COPD) patients with erectile dysfunction (ED). This was a prospective non-controlled interventional study that recruited COPD patients with ED between the ages of 49 and 79. International Index of Erectile Dysfunction Form (IIEF-5) was used for the evaluation of ED. Patients who had pulmonary artery systolic pressure >50 mmHg were included in the study. Single-dose Sildenafil 100 mg was administered orally to the patients. Before and after the drug ingestion, spirometry and echocardiographic measurements were performed, and serum BNP levels were measured as well. Forty-five male COPD patients with ED were included. Both percent predicted, and absolute FEV1 values increased significantly after the Sildenafil administration compared with baseline values (p<0.01). Similarly, the FEV1/FVC ratio also increased significantly with the Sildenafil administration compared to baseline values (p<0.01). Pulmonary artery systolic pressure significantly decreased from its baseline value with Sildenafil administration (p<0.01). Serum BNP values significantly reduced with Sildenafil administration compared to the pre-treatment values (p<0.01). This is the first study conducted in COPD patients with erectile dysfunction who had also pulmonary hypertension. The single-dose Sildenafil administration reduced PASP and serum BNP levels significantly. For the first time in the literature, we showed that the spirometric pulmonary function tests, namely FEV1 and FEV1/FVC ratio, improved significantly with the Sildenafil administration.

scholarly journals Electrocardiographic changes in Chronic Obstructive Pulmonary Disease patients with elevated Pulmonary Artery Systolic Pressure

2013 ◽  
Vol 8 (1) ◽  
pp. 12-15 ◽  
Author(s):  
S Humagain ◽  
S Keshari ◽  
R Gurung ◽  
P Pant ◽  
B Pokharel ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Artery ◽  
Pulmonary Disease ◽  
Systolic Pressure ◽  
Pulmonary Artery Systolic Pressure ◽  
Chronic Obstructive ◽  
Retrospective Case ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Significant Difference

Background Chronic Obstructive Pulmonary Disease (COPD) is a common global problem and most common medical problem in Nepal having significant morbidity and mortality. One of the pathogenesis of COPD in long run is the elevation of Pulmonary Artery Systolic Pressure (PASP) leading to right heart failure. A simple investigation - an Electrocardiograph (ECG) is assessed to co-relate with elevated PASP measured by Echocardiography in COPD patients of Dhulikhel Hospital. Methods and Materials A retrospective case control study of 342 COPD patients was done with assessment of ECG to co-relate with elevated PASP and with normal PASP. Data were analyzed using SPSS 17. Result There was significant difference in mean age, P amplitude in Lead II, III and aVF, QRS axis and R wave in V1 and S in V6 between two groups. Conclusion ECG changes are fairly sensitive and specific for elevation of PASP. DOI: http://dx.doi.org/10.3126/njh.v8i1.8330 Nepalese Heart Journal Vol.8(1) 2011 pp.12-15

scholarly journals Noninvasive Prediction of Pulmonary Hypertension in Chronic Obstructive Pulmonary Disease by Echocardiography With & It's Co-Relation With the Disease Severity (Hospital Based Study)

2018 ◽  
Vol 10 (7) ◽  
pp. 50
Author(s):  
Muhammed Waheeb Al Obaidy ◽  
Adnan M. Aljubouri ◽  
Rana Ehsan
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Hypertension ◽  
Pulmonary Artery ◽  
Pulmonary Disease ◽  
Systolic Pressure ◽  
Connective Tissue Diseases ◽  
Chronic Obstructive ◽  
Systolic Pulmonary Artery Pressure ◽  
Obstructive Pulmonary Disease ◽  
2D Echocardiography

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is one of most common cause of death. Pulmonary hypertension, one of the major and under diagnosed complications of COPD which have a great impact on outcome of COAD and associated with frequent exacerbations and bad prognosis. Echocardiography provides a rapid, noninvasive, portable, and accurate method to evaluate changes related to pulmonary hypertension in COAD.OBJECTIVE OF STUDY: Study pulmonary artery systolic pressure and Tricuspid annular plane systolic excursion in patients with COAD by 2D ECHO Doppler and correlate them with COPD severity.METHOD: Cross sectional study was conducted on 50 COPD patients in Baghdad teaching hospital (age>40 year) from first of January to the end of June, 2017. First, the diagnosis of COPD was confirmed and evaluated for staging by history, clinical examination, and spirometery.All patients have undergone ECG and 2D echocardiography and systolic pulmonary artery pressure and Tricuspid Annular Plane Systolic Excursion (TAPSE) were calculated. Patients with other cardiac or respiratory problems (asthma, pulmonary TB, lung malignancy, connective tissue diseases, interstitial lung disease, and cardiac ischemia, left side heart failure) were excluded from this study.RESULTS: Study of PASP by TR jet with the use of 2D ECHO on 50 patients with COPD showed that 20 patients had normal echo study , mild increase in PASP was found in 15 patients, moderate 11, and severe increase in 4 patients.Study of TAPSE by 2D ECHO showed that 35 patients had normal TAPSE values, while others 15 had abnormal values classified as mild, moderate, and severe: 3, 9, and 3, respectively.A significant associations between echo findings of increasing PASP and abnormal TAPSE, with decrease in FEV1, and oxygen saturation measured by pulse oximeter, duration since COPD was diagnosed and MRC dyspnea scale.CONCLUSION: High incidence of pulmonary hypertension with increasing severity of COAD. Echocardiography is useful and effective tool for detection of PHT secondary to COPD.

scholarly journals BAP 65 and DECAF scores in Predicting Outcomes in Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Prospective Observational Study

2020 ◽  
Author(s):  
Sashideep Reddy Telukutla ◽  
TA Vidya ◽  
SK Nellaiappa Ganesan
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Mechanical Ventilation ◽  
Predictive Value ◽  
Prospective Observational Study ◽  
Chronic Obstructive ◽  
Blood Gas ◽  
Invasive Ventilation ◽  
Obstructive Pulmonary Disease ◽  
Arterial Blood Gas ◽  
Arterial Blood

Introduction: Chronic Obstructive Pulmonary Disease (COPD) is the fourth most common cause of mortality in the world. Acute Exacerbation of COPD (AECOPD) is a common entity to the emergency room of physician. It also contributes to the morbidity and mortality of the disease. Since multiple factors influence the outcomes of AECOPD, many prognostic indices incorporating various parameters have been proposed. BAP 65 {Blood Urea Nitrogen (BUN), Altered mental status, Pulse rate and age >65 years} and Dyspnoea grade, Eosinopenia, Consolidation, Acidemia and Atrial fibrillation (DECAF) are two which are commonly used. Head-to-head comparisons of these scores in their ability to correctly predict outcomes will aid the clinician in decision-making. Aim: To evaluate the performance of BAP 65 and DECAF scores in accurately predicting need for mechanical ventilation and mortality in patients with AECOPD. Materials and Methods: In this prospective observational study, 170 patients presenting with AECOPD to the emergency department were recruited consecutively. All patients were clinically examined and all variables for the calculation of the two scores were documented at baseline. Routine neurological examination was used to determine altered sensorium at admission. Following this, all patients underwent appropriate investigations including chest X-ray, Electrocardiogram (ECG) and arterial blood gas estimation. BAP 65 and DECAF scores were recorded and patients were followed till death or improvement. The results were analysed using Statistical Package for the Social Sciences (SPSS) software version 23. Student’s t-test, Mann-Whitney test and Chi-square test were used depending on the type of variables. Receiver Operating Characteristic (ROC) analysis was done and Area Under the Curve (AUC) was determined. A p-value <0.5 was deemed to be significant for all tests. Results: Out of 170 patients, 48 required non-invasive ventilation and 30 required invasive ventilation and 23 (13.5%) expired. Mortality correlated significantly with age, median years of COPD, smoking pack years and hospitalisations in the past one year and also with lower haemoglobin and higher total leucocyte counts and BUN values. Both BAP 65 and DECAF scores correlated with need for mechanical ventilation and mortality. Area Under Receiver Operator Characteristic Curves (AUROC) predicting mortality was 0.712 for BAP 65 and 0.965 for DECAF scores. AUROC predicting need for ventilation was 0.583 for BAP 65 and 0.791 for DECAF scores. DECAF showed sensitivity of 78.26%, specificity of 95.92%, Positive Predictive Value (PPV) of 75%, Negative Predictive Value (NPV) of 96.58%, with an accuracy of 87.09% in predicting mortality. In predicting need for mechanical ventilation, DECAF had sensitivity of 32.14%, specificity of 94.74%, PPV of 75%, NPV of 73.97% with an accuracy of 63.44%. DECAF showed a higher positive predictive value for both outcomes. Conclusion: History and basic clinical examination provide a lot of data to formulate prognosis in AECOPD. In resource-poor settings, BAP 65 can be used while DECAF can be used where arterial blood gas analysis is readily available, since both have proven to correlate with outcomes.

scholarly journals Correlation of Arterial Blood Gas Value with Outcome of Patient Admitted with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

2020 ◽  
Vol 3 (2) ◽  
pp. 338-342
Author(s):  
Santosh Gautam ◽  
Shiva Raj KC ◽  
Milesh Jung Sijapati ◽  
Purnima Gyawali ◽  
Geetika KC ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Respiratory Failure ◽  
Hospital Stay ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Type Ii ◽  
Blood Gas ◽  
Obstructive Pulmonary Disease ◽  
Arterial Blood Gas ◽  
Arterial Blood

Background: The outcome of Chronic Obstructive Pulmonary Disease depends upon the partial pressure of oxygen and carbon dioxide This study was aimed to find the role of arterial blood gas parameters during the length of hospital stay among patients admitted for Chronic Obstructive Pulmonary Diseasewith acute exacerbation. Materials and Methods: This was an observational study conducted in KIST Medical College Teaching Hospital from February 2017 to August 2019. Patients admitted with the chronic obstructive pulmonary disease were evaluated. Demographic data as well as oxygen saturation (SPO2), pulmonary function test, and arterial blood gas analysis were recorded and analyzed. Results: Among 112 patients, the female to male ratio was 1.38: 1 with 84.8% over 60 years of age. One-third of patients (n=38) had exposure to both tobacco smoking and biomass and of them, 86.8% were females. Mean SpO2 was 75.9% and mean FEV1 was 0.92 L (SD=0.295) and significant association was found (p<0.001) between them. Furthermore, 70 (62.5%) patients had type I respiratory failure and 42 patients (37.5%) had type II respiratory failure. Patients with type II respiratory failure and hypercapnic patients had prolonged hospital stay with significant p-value (p<0.001). Similarly, significance was observed in the p-value for acidic blood pH, which was <0.05. Conclusions: Increased length of hospital stay is seen in patients with acute exacerbation of Chronic Obstructive Pulmonary Disease with type II respiratory failure. Hence, aggressive early management to correct hypercapnia may lead to decreased hospital stay along with a better outcome. Thus hypercapnia should be considered as one of the important criteria to flag the patient and manage accordingly. 

Correlation of Arterial blood gas value in outcome of patient admitted with acute exacerbation of Chronic Obstructive Pulmonary Disease

2020 ◽  
Author(s):  
Santosh Gautam ◽  
Shiva Raj K C ◽  
Milesh Jung Sijapati ◽  
Purnima Gyawali ◽  
Geetika KC ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Respiratory Failure ◽  
Hospital Stay ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Type Ii ◽  
Blood Gas ◽  
Obstructive Pulmonary Disease ◽  
Arterial Blood Gas ◽  
Arterial Blood

Abstract Introduction: The outcome of Chronic Obstructive Pulmonary Disease depends upon the partial pressure of oxygen and carbon dioxide This study was aimed to find the role of arterial blood gas parameters during the length of hospital stay among patients admitted for COPD with acute exacerbation. Materials and Methods: This was an observational study conducted in KIST Medical College Teaching Hospital from February 2017 to August 2019. Patients admitted with chronic obstructive pulmonary disease were evaluated. Demographic data as well as SPO2, pulmonary function test, and arterial blood gas analysis were recorded and analyzed. Results: Among 112 patients, the female to male ratio was 1.38: 1 with 84.8% over 60 years of age. One-third of patients (n = 38) had exposure to both tobacco smoking and biomass and of them, 86.8% were females. Mean SpO2 was 75.9% and mean FEV1 was 0.92 L (SD = 0.295) and significant association was found (p < 0.001) between them. Furthermore, 70 (62.5%) patients had type I respiratory failure and 42 patients (37.5%) had type II respiratory failure. Patients with type II respiratory failure and hypercapnic patients had prolonged hospital stay with significant p-value (p < 0.001). Similarly, significance was observed in the p-value for blood pH, which was < 0.05. Conclusions: Increased length of hospital stay is seen in patients with AECOPD with type II respiratory failure. Hence, aggressive early management to correct hypercapnia may lead to decreased hospital stay along with a better outcome. Thus hypercapnia should be considered as one of the important criteria to flag the patient and manage accordingly.

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