scholarly journals THE EFFECT OF PROLONGED OXYGEN THERAPY ON THE CLINICAL COURSE OF THE DISEASE AND DIAPHRAGM FUNCTION IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND HYPOXEMIC RESPIRATORY FAILURE (THREE-YEAR FOLLOW-UP)

2019 ◽  
Vol 97 (9) ◽  
pp. 45-51
Author(s):  
O. N. TITOVА ◽  
◽  
N. А. KUZUBOVА ◽  
D. B. SKLYAROVА ◽  
V. А. VOLCHKOV ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Respiratory Failure ◽  
Pulmonary Disease ◽  
Oxygen Therapy ◽  
Clinical Course ◽  
Chronic Obstructive ◽  
Hypoxemic Respiratory Failure ◽  
Obstructive Pulmonary Disease ◽  
Diaphragm Function

scholarly journals The influence of oxygenotherapy on the hypercapnia in patients with chronic obstructive pulmonary disease

2008 ◽  
Vol 65 (7) ◽  
pp. 521-524
Author(s):  
Zorica Lazic ◽  
Ivan Cekerevac ◽  
Ljiljana Novkovic ◽  
Vojislav Cupurdija
Keyword(s):  
Carbon Dioxide ◽  
Chronic Obstructive Pulmonary Disease ◽  
Respiratory Failure ◽  
Pulmonary Disease ◽  
Oxygen Therapy ◽  
Chronic Obstructive ◽  
Average Increase ◽  
Obstructive Pulmonary Disease ◽  
Initial Values ◽  
Arterial Blood

Background/Aim. Oxygen therapy is a necessary therapeutic method in treatment of severe chronic respiratory failure (CRF), especially in phases of acute worsening. Risks which are to be taken into consideration during this therapy are: unpredictable increase of carbon dioxide in blood, carbonarcosis, respiratory acidosis and coma. The aim of this study was to show the influence of oxygen therapy on changes of arterial blood carbon dioxide partial pressure. Methods. The study included 93 patients in 104 admittances to the hospital due to acute exacerbation of CFR. The majority of the patients (89.4%) had chronic obstructive pulmonary disease (COPD), while other causes of respiratory failure were less common. The effect of oxygenation was controlled through measurement of PaO2 and PaCO2 in arterial blood samples. To analyze the influence of oxygen therapy on levels of carbon dioxide, greatest values of change of PaO2 and PaCO2 values from these measurements, including corresponding PaO2 values from the same blood analysis were taken. Results. The obtained results show that oxygen therapy led to the increase of PaO2 but also to the increase of PaCO2. The average increase of PaO2 for the whole group of patients was 2.42 kPa, and the average increase of PaCO2 was 1.69 kPa. There was no correlation between the initial values of PaO2 and PaCO2 and changes of PaCO2 during the oxygen therapy. Also, no correlation between the produced increase in PaO2 and change in PaCO2 during this therapy was found. Conclusion. Controlled oxygen therapy in patients with severe respiratory failure greatly reduces the risk of unwanted increase of PaCO2, but does not exclude it completely. The initial values of PaO2 and PaCO2 are not reliable parameters which could predict the response to oxygen therapy.

scholarly journals Diagnostic importance of natriuretic peptide in chronic obstructive pulmonary disease with chronic hypoxemic respiratory failure

2020 ◽  
Vol 4 (4) ◽  
pp. 174-179
Author(s):  
N.A. Kuzubova ◽  
◽  
O.N. Titova ◽  
V.A. Volchkov ◽  
D.B. Sklyarova ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Hypertension ◽  
Respiratory Failure ◽  
Pulmonary Disease ◽  
Natriuretic Peptide ◽  
Chronic Obstructive ◽  
Hypoxemic Respiratory Failure ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Diagnostic Importance

Background: the progression of chronic obstructive pulmonary disease (COPD) is accompanied by pulmonary hypertension and right ventricular failure as well as left ventricular failure that can be associated with the elevated levels of N-terminal pro b-type natriuretic peptide (NT-proBNP). Aim: to evaluate the diagnostic importance of NT-proBNP in COPD with chronic hypoxemic respiratory failure. Patients and Methods: 60 patients with COPD GOLD stage 3 and 4 (group D, mixed phenotype: emphysematous bronchitic) during remission were examined. Mean age was 64.78±6.9 years. The patients were divided into three groups. Group 1 included 20 COPD patients with hypoxemia who received long-term oxygen therapy (LTOT). Group 2 included 20 COPD patients with hypoxemia who did not receive LTOT. Group 3 included 20 COPD patients with normoxemia. After the primary examination, group 1 patients were prescribed with in-home LTOT (16 hours daily). Group 2 and 3 patients were not prescribed with LTOT. All patients received basic treatment, i.e., a combined drug containing an inhaled corticosteroid and β2-agonist (budesonide/formoterol 400/12 μg twice daily) and a long-acting muscarinic antagonist (tiotropium bromide 2.5 μg, 2 inhalations once daily). The patients were reexamined after 12 months. Arterial blood gases and serum NT-proBNP concentration were measured, spirometry and Doppler echocardiography were performed. Results: NT-proBNP levels in COPD patients with hypoxemia were significantly elevated. The associations between NT-proBNP and partial oxygen arterial pressure (r= -0.71, p<0.05), NT-proBNP and pulmonary artery systolic pressure (PASP) (r=0.61, p<0.05) were revealed. ROC analysis of NT-proBNP demonstrated its sensitivity and specificity in COPD patients with the different severity of respiratory failure. LTOT for COPD with hypoxemia reduces PASP, improves left ventricular diastolic function, and decreases NT-proBNP levels. Conclusions: as chronic hypoxemic respiratory failure progresses in COPD, NT-proBNP concentration increases. ROC analysis demonstrates that NT-proBNP can be considered as a promising marker of hypoxemia and pulmonary hypertension. LTOT reduces NT-proBNP levels by improving pulmonary cardiac hemodynamics. KEYWORDS: COPD, hypoxemia, natriuretic peptide, long-term oxygen therapy, pulmonary hypertension, diastolic dysfunction, right ventricle. FOR CITATION: Kuzubova N.A., Titova O.N., Volchkov V.A., Sklyarova D.B. Diagnostic importance of natriuretic peptide in chronic obstructive pulmonary disease with chronic hypoxemic respiratory failure. Russian Medical Inquiry. 2020;4(4):174–179. DOI: 10.32364/2587-6821- 2020-4-4-174-179.

Midterm Results of Routine Bilateral Internal Thoracic Artery Grafting

2005 ◽  
Vol 6 (5) ◽  
pp. 348 ◽  
Author(s):  
A. Kramer ◽  
R. Mohr ◽  
O. Lev-Ran ◽  
R. Braunstein ◽  
D. Pevni ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Regression Analysis ◽  
Pulmonary Disease ◽  
Internal Thoracic Artery ◽  
Chronic Obstructive ◽  
Midterm Results ◽  
Obstructive Pulmonary Disease ◽  
Sternal Infection ◽  
Repeat Operation

Background: Skeletonized dissection of the internal thoracic artery (ITA) decreases the occurrence of sternal devascularization, thus decreasing the risk of postoperative sternal complications in patients undergoing bilateral ITA grafting. Methods: From April 1996 to July 1999, 1000 consecutive patients underwent bilateral skeletonized ITA grafting. Of the 770 male and 230 female patients, 420 were older than 70 years, and 312 had diabetes. Results: Operative mortality was 3.3%. Follow-up (4078 months) revealed 79 late deaths, and the Kaplan-Meier 6-year survival rate was 88%. Cox regression analysis revealed increased overall mortality (early and late) in patients with preoperative congestive heart failure (risk ratio [RR], 2.13; 95% confidence interval [CI], 1.31-3.45), in patients with peripheral vascular disease (RR, 5.52; 95% CI, 3.31-9.19), and in patients older than 70 years (RR, 2.18; 95% CI, 1.37-3.47). Early postoperative morbidity included sternal infection (2.2%), cerebrovascular accident (1.6%), and perioperative myocardial infarction (1%). Multiple regression analysis showed repeat operation (odds ratio [OR], 7.5; 95% CI, 1.77-31.6) and chronic obstructive pulmonary disease (OR, 3.6; 95% CI, 1.27-10.75) to be independent predictors of sternal infection. During follow-up, angina returned in 95 patients, 24 of whom required reintervention (20 cases of percutaneous balloon angioplasty and 4 reoperations). Postoperative coronary angiography performed in 87 patients revealed an ITA patency rate of 91%. Conclusions: Bilateral skeletonized ITA grafting is associated with satisfactory early and midterm results. We do not recommend the use of this surgical technique in patients with chronic obstructive pulmonary disease.

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