The role of presepsin in the diagnosis of chronic obstructive pulmonary disease acute exacerbation with pneumonia

2020 ◽  
Vol 14 (1) ◽  
pp. 31-41
Author(s):  
Ali Halıcı ◽  
İzzettin Hür ◽  
Kerim Abatay ◽  
Esra Çetin ◽  
Filiz Halıcı ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Acute Exacerbation ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Acute Exacerbation Of Copd ◽  
Group 3 ◽  
Group 2 ◽  
Exacerbation Of Copd ◽  
Group 1

Aim: In this study, we aimed to investigate the role of presepsin in detecting concomitant pneumonia in patients presenting with acute exacerbation of chronic obstructive pulmonary disease (COPD) in the emergency department. Patients & methods: Three groups were formed in the study. Group 1: patients diagnosed with acute exacerbation of COPD; group 2: patients with acute exacerbation of COPD + pneumonia; group 3: healthy individuals. Results: Presepsin levels of the patients in group 2 were significantly higher than those of group 1 and group 3 (p < 0.05). There was a statistically significant difference in erythrocyte sedimentation rate, CRP, procalcitonin and presepsin values between two patient groups (p < 0.05). Conclusion: Presepsin can be used to diagnose pneumonia in patients with acute exacerbation of COPD admitted to the emergency department.

scholarly journals Serum biomarkers in patients with stable and acute exacerbation of chronic obstructive pulmonary disease: A comparative study

2019 ◽  
Vol 38 (4) ◽  
pp. 503-511 ◽  
Author(s):  
Füsun Şahin ◽  
Ayşe Filiz Koşar ◽  
Ayşe Feyza Aslan ◽  
Burcu Yiğitbaş ◽  
Berat Uslu
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Distribution Width ◽  
Lymphocyte Ratio ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Summary Background Mean platelet volume (MPV), neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have all been investigated as novel inflammatory markers of cardiac and oncological diseases, while there is only a limited number of studies investigating these markers in chronic obstructive pulmonary disease (COPD). In the present study we examine NLR, PLR; and other markers, such as eosinophil, MPV, plateletcrit (PCT), platelet distribution width (PDW), red cell distribution width (RDW), and C-reactive protein (CRP) in patients with stable and acute exacerbation of COPD. Methods Stable COPD (Group 1, n=140), COPD with acute exacerbation (Group 2, n=110), and healthy controls (Group 3, n=50) were included in the study. Leukocyte, CRP, hemoglobin (HB), RDW, platelet, MPV, PCT, PDW, neutrophil, lymphocyte, eosinophil, NLR, and PLR were analyzed in all groups. Results HB, leukocyte, platelet, neutrophil, eosinophil, MPV, PCT, CRP, NLR, and PLR were significantly higher, while the lymphocyte was lower in Group 1 than in Group 3. Leukocyte, neutrophil, RDW, CRP, NLR, and PLR were significantly higher, while lymphocyte was lower in Group 2 than in Group 3. Leukocyte, neutrophil, RDW, CRP, NLR, and PLR were significantly higher, while HB, platelet, MPV, PCT, and lymphocyte were significantly lower in Group 2 than in Group 1. NLR and PLR increased significantly in patients with bronchiectasis when compared to those without in Group 1. Conclusions Our study results suggest that NLR, PLR and RDW can be used as simple and cost-effective markers for the evaluation of severity of exacerbation and for predicting hospitalization and further exacerbations in patients with COPD.

scholarly journals Study of Serum B-Type Natriuretic Peptide (BNP) Levels as a Prognostic Marker in Acute Exacerbation of COPD in HSK Hospital, Bagalkot, Karnataka

2021 ◽  
Vol 8 (19) ◽  
pp. 1332-1335
Author(s):  
Sunil Baragi ◽  
Kadappa Jaligidad ◽  
Joachim Piedade Souza
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Hypertension ◽  
Partial Pressure ◽  
Acute Exacerbation ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Acute Exacerbation Of Copd ◽  
Duration Of Hospital Stay ◽  
Life Threatening ◽  
Exacerbation Of Copd

BACKGROUND Pulmonary hypertension (PH) and heart failure are common comorbidities in 20 – 30 % of chronic obstructive pulmonary disease (COPD) patients with acute exacerbation. Similarities in signs and symptoms and lack of objective measures to stratify them at emergency department makes the management difficult. Echocardiography though useful requires specialised training. Hence, B-Type Natriuretic Peptide (BNP) is a simple test that can prognosticate the severity and can influence management in such patients. The purpose of the study was to estimate the significance of BNP during acute exacerbation of chronic obstructive pulmonary disease (AECOPD) as an important marker of severity and to study its correlation with duration of hospital stay, place and mode of management in patients with severe and life-threatening exacerbation of COPD. METHODS This is a prospective longitudinal observational study conducted on 50 patients of severe and life-threatening COPD exacerbation admitted to General Medicine department of HSK hospital, Bagalkot and their outcomes were noted based on the BNP levels. RESULTS The study showed higher levels of BNP in patients admitted to ICU as compared to emergency ward (P = 0.001). Greater values among those on invasive mechanical ventilation vs. non-invasive ventilation (NIV). There was a positive correlation and statistical significance of BNP values with arterial blood gases (ABG) parameters like pulmonary hypertension (PH), partial pressure of carbondi-oxide (PaCO2), partial pressure of oxygen (PaO2), echo parameters like right ventricle (RV) diameter and pulmonary artery systolic pressure (PASP) and duration of hospital stay. CONCLUSIONS BNP is a simple, low cost and easily available blood test that can prognosticate oxygen requirement, mode of ventilation, place of management and can grade and reflect the severity in acute exacerbation of COPD. KEYWORDS AECOPD, BNP, Prognostic Marker, Outcome

Serum Electrolyte in Acute Exacerbation of Chronic Obstructive Pulmonary Disease

2020 ◽  
Vol 13 (1) ◽  
pp. 9-13
Author(s):  
Chandra Prasad Acharya ◽  
Kalpana Paudel
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Chronic Obstructive ◽  
Serum Electrolyte ◽  
Obstructive Pulmonary Disease ◽  
Acute Exacerbation Of Copd ◽  
Electrolyte Disorder ◽  
The Mean ◽  
Exacerbation Of Copd

Introduction: Chronic Obstructive Pulmonary Disease (COPD) is one of the leading causes of mortality and morbidity worldwide. Though COPD is mainly a chronic disease, many patients experience exacerbations that are related to worst survival outcome, especially with abnormal serum electrolyte level. The objective of this study was to evaluate serum electrolyte levels among the patients with acute exacerbation of COPD. Methods: Structured questionnaire and patients’ charts were used to collect data. Data was analyzed using Statistical Package for the Social Sciences (SPSS) software version 16.0 and descriptive statistics were used to generate the research findings. Results: The mean age of the patients with Acute exacerbation of COPD was 69.57± 9.765 years. Among 100 patients, (83%) belonged to the age group of 60 years and above, (54%) were male, (74%) were married, (52%) were illiterate and (41%) were engaged in agriculture, (41%) consumed alcohol and (67%) were smokers. Dyspnoea (90%) was the most common symptom. The mean level of sodium and potassium were 133.8±4.830 mEq/L, 3.6±0.533 mmol/L, respectively. Fifty seven percent patients had electrolyte disorder. More than half (51%) had hyponatremia and (40%) had hypokalemia. The average value of pH, PaCO2 and PaO2 are 7.34 ± 0.727, 46.64 ± 9.787 mm Hg and 69.38 ± 9.255 mm Hg respectively. Among them, (18%) were in respiratory failure. Conclusion: This study concluded that hyponatremia and hypokalemia are prevalent electrolyte disorder with AE of COPD patients. Therefore, we recommend routine monitoring of the serum electrolytes for better outcomes of patients.

scholarly journals Possibilities to prevent acute exacerbation of chronic obstructive pulmonary disease using inhalational therapy. A Report of Expert Panel of Russian Respiratory Society

2018 ◽  
Vol 28 (3) ◽  
pp. 368-380 ◽  
Author(s):  
S. N. Avdeev ◽  
A. S. Belevskiy ◽  
Z. R. Aisanov ◽  
V. V. Arkhipov ◽  
I. V. Leshchenko ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Clinically Significant ◽  
Long Acting ◽  
Exacerbation Of Copd ◽  
Inhalational Therapy

An impact of acute exacerbation of COPD (AECOPD) on the course and the prognosis of chronic obstructive pulmonary disease depends on severity of the exacerbation. Moderate and severe exacerbations are considered as clinically significant events. Clinical studies investigating a role of inhalational therapy for the risk of AECOPD differed significantly in important parameters and the patients involved were not fully described in the real clinical practice. Tiotropium alone did not demonstrate any benefit over other inhalational therapies, such as inhaled corticosteroid/long-acting β2-agonist (ICS/LABA) combinations and long-acting muscarinic antagonist (LAMA)/LABA combinations, for risk reduction of moderate to severe exacerbations. A benefit of tiotropium/olodaterol combination over tiotropium for the reduction of risk of clinically significant exacerbations was first shown in DYNAGITO study; patients’ groups in this study did not differ in a rate and a spectrum of adverse events including cardiovascular events. An efficient bronchodilating therapy should be administered to all patients with COPD as it could improve dyspnea and prevent exacerbations. Further escalation of treatment in patients with frequent exacerbations of COPD should be personalized according to clinical course and causes of AECOPD. 

Pilot Study to Assess the Credibility of Acupuncture in Acute Exacerbations of Chronic Obstructive Pulmonary Disease

2009 ◽  
Vol 27 (1) ◽  
pp. 13-15 ◽  
Author(s):  
Claudia A Whale ◽  
Sarah J A MacLaran ◽  
Christopher I Whale ◽  
Mandy Barnett
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pilot Study ◽  
Visual Analogue Scale ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Analogue Scale ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Acute Exacerbation Of Copd ◽  
Exacerbation Of Copd

Background Exacerbation of chronic obstructive pulmonary disease (COPD) is a common reason for hospital admission, and adjunctive non-pharmacological treatments would be welcomed. A pilot study was undertaken to assess the feasibility of conducting a study of acupuncture during an acute exacerbation of COPD. We also examined the credibility of a sham device in this setting and assessed the effect of acupuncture on breathlessness and anxiety. Methods A prospective, randomised, patient- and assessor-blinded, sham controlled study was conducted on three consecutive days in a district general hospital. Credibility of both acupuncture and the Park sham device were assessed using the Borkovec and Nau questionnaire. Dyspnoea was measured on the modified Borg score and a 10 cm visual analogue scale, while anxiety was measured on a 10 cm visual analogue scale. Results 11 patients were recruited and nine completed the study. There were no adverse events with either intervention. Acupuncture was well tolerated and credibility scores were similar before and after real and sham acupuncture. Symptoms improved after both treatments, with no significant difference between groups. Conclusion In this pilot study acupuncture was well tolerated by subjects experiencing an acute exacerbation of COPD. Acupuncture treatment and the Park sham device were both credible. Although recruitment was slow, a further trial with a larger sample size is feasible and recommended.

scholarly journals ANTIBIOTIC THERAPY IN ACUTE EXACERBATION OF COPD:AN OPTIMAL WAY TO SUCCESS

2021 ◽  
Vol 29 (2) ◽  
pp. 35-40
Author(s):  
L. V. Yudina
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Antibiotic Therapy ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Chronic Obstructive ◽  
Family Practitioner ◽  
Copd Exacerbation ◽  
Obstructive Pulmonary Disease ◽  
Acute Exacerbation Of Copd ◽  
Exacerbation Of Copd

Currently, chronic obstructive pulmonary disease (COPD) is the third leading cause of death globally. Acute exacerbation of the disease is associated with fast clinical deterioration, increased respiratory tract inflammation and lung function disorders. Acute exacerbation of COPD dramatically worsens patient�s prognosis and serves as an important indicator of therapy effectiveness. Family practitioner should recognize this condition and correctly chose proper antibiotic. Diagnosis of COPD exacerbation is based on clinical manifestations of the disease. Depending on presence of primary or secondary symptoms COPD exacerbations are divided into several types. Antibiotic therapy appears to be more beneficial in patients with type 2 or 3 exacerbation. Sputum purulence is considered an obligatory symptom. As a rule, in complicated course of acute exacerbation of COPD protected aminopenicillins or 3rd generation cephalosporins are the firsline antibiotics. In most cases of COPD exacerbation antibiotics are prescribed orally. If first-line antibacterial therapy fails, the respiratory fluoroquinolones (levofloxacin of moxifloxacin) are prescribed. The author, using her own experience with levofloxacin, gives an example of proper choice of antibiotic if such a situation. Successful experience of management of acute exacerbation of COPD may be useful for general practitioners, physicians, pulmonologists. Key words: chronic obstructive pulmonary disease, exacerbation, antibiotic therapy, levofloxacin.

scholarly journals Study of Factors Determining Outcomes in the Hospitalized Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease (COPD)

2014 ◽  
Vol 2 (2) ◽  
pp. 28-34
Author(s):  
MJ Sijapati ◽  
N Bhatta ◽  
B Khanal ◽  
M Lamsal ◽  
S Chaudhary
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Univariate Analysis ◽  
Hospitalized Patients ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Acute Exacerbation Of Copd ◽  
Arterial Blood ◽  
Exacerbation Of Copd

BACKGROUND: Chronic Obstructive Pulmonary Disease (COPD) is a major cause of mortality and morbidity across the world. Information related to the factors associated with COPD exacerbation and factors determining outcome in hospitalized patient with acute exacerbation of COPD are very important for effective long-term management of this disease. Within this background we attempted to study the factors determining outcome in hospitalized patients with acute exacerbation of COPD. METHODS: The study was prospective observational study. Hundred consecutive patients hospitalized with acute exacerbation of COPD were prospectively assessed. RESULTS: Patients required mechanical ventilation and Intensive Care Unit (ICU) transfer were 17 (17%). Patients with hypercapnia pCO2 [(80.24 ± 10.76mmHg P=0.001], pH [(7.24 ± 0.062) P=0.004] with type 2 respiratory failure required ICU transfers with mechanical ventilatory support and these variables were statistically significant in univariate analysis. Patients who were in COPD stage III (FEV1/FVC ratio < 0.35) and having the poor arterial blood gas parameters pH (7.24±0.02) P=0.001, pCO2 [(76.5±13.12mmHg,P=0.006] had bad prognosis. The patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD) who were smokers and exposed to indoor air pollution due to use of biomass fuels had poor outcomes. CONCLUSION: Patients with AECOPD hospitalized in a tertiary care center in a developing country suggest that FEV1/FVC impairment, decreased pH, increased pC02, current smoking status and presence of biomass exposure are associated with prolonged hospitalization, ICU admission and death. DOI: http://dx.doi.org/10.3126/jucms.v2i2.11171   Journal of Universal College of Medical Sciences (2014) Vol.2(2): 28-34

The Role of Music in Improving Exercise Capacity in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease as Measured by the 2-minute Walking Test

2015 ◽  
Vol 7 (4) ◽  
pp. 32 ◽  
Author(s):  
Anuk Kruavit ◽  
Eugene Teh ◽  
Imogen Clark ◽  
Vikas Vadhwa
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Music Therapy ◽  
Acute Exacerbation ◽  
Exercise Capacity ◽  
Walking Distance ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Walking Test ◽  
Acute Exacerbation Of Copd ◽  
Exacerbation Of Copd

Background: Studies have shown that music has positive effects on quality of life and increases exercise capacity of patients with chronic obstructive pulmonary disease (COPD). We evaluated the effects of music on exercise capacity in COPD inpatients. Method: This was a prospective, interventional study involving patients with an acute exacerbation of COPD. Patients selected, from a pre-determined list, their preferred song rated as having the best motivational score, as per the Brunel Music Rating Inventory. A 2-minute walking test was undertaken with and without music. The walking distance and degree of dyspnoea were recorded after each walking test. Secondary outcomes included walking time, blood pressure, heart rate, respiratory rate and oxygen saturation with and without music. Results: 17 patients were recruited, with a mean age of 73.9 ± 8.6 years. 9 were males and 8 were females. There was a significant increase in the walking distance with music, with a mean increase in distance of 7.94 metres (95% CI, 3.58 – 12.31). There was a non-significant trend that patients could walk for a longer time with music therapy. Diastolic blood pressure also increased significantly with music therapy, but other physiological parameters did not show any significant changes. The motivational score of the preferred song used did not lead to any significant correlation with the outcome variables. Conclusion: The use of music with a patient-preferred song may lead to significant clinical benefits in hospital inpatients with acute exacerbation of COPD. Larger studies are warranted to provide further evidence for its potential use in routine clinical practice.

scholarly journals Presence of Cardiac Troponin I in Patients with Acute Exacerbation of COPD

2020 ◽  
pp. 11-15
Author(s):  
U. T. Mane ◽  
Rahul S. Patil ◽  
A. T. Pardesi ◽  
Anil Bhattad ◽  
Vaibhav Agarwal
Keyword(s):  
Acute Exacerbation ◽  
Cardiac Troponin ◽  
Troponin I ◽  
Cardiac Troponin I ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Acute Exacerbation Of Copd ◽  
Male Preponderance ◽  
Group 2 ◽  
Exacerbation Of Copd

Chronic obstructive pulmonary disease (COPD) is frequently associated with right ventricular loading and pulmonary hypertension. We aimed to evaluate a possible association between cardiac troponin I (cTnI) levels and adverse events in hospitalized patients with acute exacerbation of COPD. 120 Patients with acute exacerbation of COPD were studied between 18 months (October 2014 to March 2016). A Male preponderance was found with M: F ratio being 3:2. 35% were current smokers. In hospital mortality in group 1 was 14.3% and in group 2 was 1.9%. Thus cardiac troponin I can be taken as a marker to identify high risk patients during acute exacerbation of COPD.

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