scholarly journals Exacerbation of COPD Treatment Combination Therapy NIV with Thermal Helium- Oxygen Plus Nitric Oxide: A Case Report

2021 ◽  
pp. 1-3
Author(s):  
TT Truong ◽  
◽  
LV Shogenova ◽  
Keyword(s):  
Nitric Oxide ◽  
Clinical Course ◽  
Respiratory Acidosis ◽  
Chronic Obstructive ◽  
Severe Exacerbation ◽  
Obstructive Pulmonary Disease ◽  
History Of ◽  
Pulmonary Arterial ◽  
Exacerbation Of Copd ◽  
Copd Mortality

Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality worldwide despite increased health care efforts, financial costs, and research concerning its early diagnosis and proper management [1]. The most relevant event affecting COPD mortality is the acute exacerbation of COPD (AECOPD), a catastrophic event during the clinical course of the disease [2]. In cases of acute respiratory acidosis, noninvasive mechanical ventilation (NIV) is considered. Nevertheless, in 30% of patients with severe exacerbation of COPD, NIV does not lead to the desired results [3]. However, there have been cases of NIV failure in patients with severe respiratory acidosis, and associated pulmonary arterial hypertension. Many studies have shown that thermal helium-oxygen and nitric oxide gas heat treatment has many effects. Here we are reporting a case of severe exacerbation COPD, 67 years old male patient, who came to us with shortness of breath, fever, wheezing and a cough with yellow phlegm. He had a history of smoking 30 pack-year smoker many years. He was given NIV treatment with a combination of helium and nitric oxide heat. And we have had very good results.

scholarly journals Chronic Obstructive Lung Disease in young: Alpha 1 anti trypsin deficiency

2015 ◽  
Vol 3 (2) ◽  
pp. 65-67
Author(s):  
S.S. Dhakal ◽  
K.K. Agrawaal ◽  
N.K. Bhatta
Keyword(s):  
Bronchial Asthma ◽  
Clinical Manifestations ◽  
Lower Lobe ◽  
Chronic Obstructive Lung Disease ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Severe Deficiency ◽  
History Of ◽  
Pulmonary Arterial ◽  
Alpha 1 Antitrypsin

Alpha-1 antitrypsin (AAT) deficiency is a clinically under recognized inherited disorder. The main clinical manifestations relate to three separate organs: the lung, the liver, and the skin. In the lung, severe deficiency of AAT predisposes to chronic obstructive pulmonary disease. We present a case of 34 years male with a history of recurrent chest infections in past and treated in the line of bronchial asthma but not relieved. He was admitted on 22nd May 2011 at BPKIHS. He presented with type 2 respiratory failure and had features of severe pulmonary arterial hypertension and left lower lobe pneumonia. The patient got improved with the treatment and is doing well on follow up. The diagnosis should be strongly suspected in patients with history suggestive of bronchial asthma and with obstructive features.Journal of Advances in Internal Medicine 2014;3(2):65-67

scholarly journals Infective Exacerbation ofPasteurella multocida

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Mayumi Hamada ◽  
Noha Elshimy ◽  
Hatem Abusriwil
Keyword(s):  
Pasteurella Multocida ◽  
Complete Recovery ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Left Hand ◽  
History Of ◽  
Chest X Ray ◽  
Animal Bites ◽  
Exacerbation Of Copd ◽  
Severe Type

An 89-year-old lady presented with a one-day history of shortness of breath as well as a cough productive of brown sputum. Her medical history was significant for chronic obstructive pulmonary disease (COPD). She was in severe type one respiratory failure and blood tests revealed markedly raised inflammatory markers; however her chest X-ray was clear. On examination there was bronchial breathing with widespread crepitations and wheeze. She was treated as per an infective exacerbation of COPD. Subsequent blood cultures grewPasteurella multocida, a common commensal in the oropharynx of domesticated animals. The patient was then asked about any contact with animals, after which she revealed she had a dog and was bitten on her left hand the day before admission. We should not forget to enquire about recent history of injuries or animal bites when patients present acutely unwell. She made a complete recovery after treatment with penicillin.

scholarly journals A STUDY OF MODIFIED DECAF SCORE IN PREDICTING HOSPITAL MORTALITY IN PATIENTS OF ACUTE EXACERBATIONS OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE

2019 ◽  
Vol 3 (9) ◽  
Author(s):  
Dr. Sumit Prakash ◽  
Dr. Shruti Jain ◽  
Dr. Lalit Singh ◽  
Dr. Rajeev Tandon
Keyword(s):  
Hospital Mortality ◽  
Acute Exacerbation ◽  
Respiratory Acidosis ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Acute Exacerbation Of Copd ◽  
Social Burden ◽  
Prediction Of Mortality ◽  
Study Population ◽  
Exacerbation Of Copd

Background:  COPD is a leading cause of morbidity and mortality worldwide and results in an economic and social burden that is both substantial and increasing .The modified DECAF score was derived for accurate prediction of mortality and risk stratification to inform patient care. Methods: Hospital based descriptive type of observational study was. After applying inclusion and exclusion criterias, study population for acute exacerbation of COPD was selected. Admission clinical data, including modified DECAF indices, and mortality were recorded. Results: In our study there was a statistically significant value (p <0.05) between grade of dyspnea, respiratory acidosis (pH < 7.30) and frequency of admission in the Modified DECAF score and in-hospital mortality of Acute Exacerbation of COPD. There was insignificant relationship between Eosinopenia & consolidation and in hospital mortality  Conclusion-We concluded that the Modified DECAF score is a powerful score to predict in hospital mortality from AECOPD. Keywords: COPD, DECAF, Exacerbations, Modified DECAF.

Vasoactive mediators and pulmonary hypertension after cigarette smoke exposure in the guinea pig

2006 ◽  
Vol 100 (2) ◽  
pp. 672-678 ◽  
Author(s):  
Joanne L. Wright ◽  
Hsin Tai ◽  
Andrew Churg
Keyword(s):  
Gene Expression ◽  
Nitric Oxide ◽  
Arterial Pressure ◽  
Cigarette Smoke ◽  
Pulmonary Arterial Pressure ◽  
Smoke Exposure ◽  
Cigarette Smoke Exposure ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Pulmonary Arterial

The pathogenesis of pulmonary hypertension in patients with chronic obstructive pulmonary disease is not understood. We have previously shown increased levels of mediators that control vasoconstriction (endothelin-1), vascular cell proliferation (endothelin-1 and vascular endothelial growth factor), and vasodilation (endothelial nitric oxide synthase) in the intrapulmonary arteries of animals exposed to cigarette smoke. To determine whether these mediators could be implicated in the structural remodeling of the arterial vasculature and increased pulmonary arterial pressure caused by chronic cigarette smoke exposure, guinea pigs were exposed to daily cigarette smoke for 6 mo. Pulmonary arterial pressures were measured. Intrapulmonary artery structure was analyzed by morphometry, artery mediator protein expression by immunohistochemistry, and artery mediator gene expression by laser capture microdissection and real-time RT-PCR. We found that the smoke-exposed animals developed increases in pulmonary arterial pressure and increased muscularization of the small pulmonary arteries. Gene expression and protein levels of all three mediators were increased, and pulmonary arterial pressure correlated both with the levels of mediator production and with the degree of arterial muscularization. We conclude that chronic smoke exposure produces increased vasoactive mediator expression in the small intrapulmonary arteries and that these mediators are associated with vascular remodeling as well as increased pulmonary arterial pressure. These findings support the idea that hypertension in chronic obstructive pulmonary disease is a result of direct cigarette smoke-mediated effects on the vasculature and suggest that interference with endothelin and VEGF production and activity or augmentation of nitric oxide levels may be beneficial.

scholarly journals THE STATE OF ENDOTHELIUM-DEPENDENT VASOREGULATION IN THE DYNAMICS OF THE EFFECT OF A NON-DRUG THERAPY COMPLEX IN PATIENTS WITH PULMONARY ARTERIAL HYPERTENSION

2017 ◽  
Vol 16 (6) ◽  
pp. 315-319
Author(s):  
A. L Alyavi ◽  
Dilorom Alimovna Rakhimova ◽  
Z. T Sabirzhanova
Keyword(s):  
Nitric Oxide ◽  
Chronic Obstructive Pulmonary Disease ◽  
Standard Therapy ◽  
Pulmonary Arterial Pressure ◽  
Chronic Obstructive ◽  
Complex Treatment ◽  
Obstructive Pulmonary Disease ◽  
Mean Pulmonary Arterial Pressure ◽  
Pulmonary Arterial ◽  
The Right

After complex treatment with the use of ozonotherapy and bischofite electrophoresis on the background of standard therapy, the parameters of diastolic function of the right ventricle, mean pulmonary arterial pressure, the level of stable metabolites of nitric oxide, endothelium-dependent vasoregulation and psychoemotional status in patients with chronic obstructive pulmonary disease complicated by the development of chronic pulmonary heart were improved against standard therapy.

scholarly journals Ischemic Heart Disease during Acute Exacerbations of COPD

2018 ◽  
Vol 6 (4) ◽  
pp. 83
Author(s):  
Rosa Malo de Molina ◽  
Silvia Aguado ◽  
Carlos Arellano ◽  
Manuel Valle ◽  
Piedad Ussetti
Keyword(s):  
Cardiovascular Events ◽  
Imaging Techniques ◽  
Beta Blockers ◽  
Chronic Obstructive ◽  
Severe Exacerbation ◽  
Obstructive Pulmonary Disease ◽  
Systemic Oxidative Stress ◽  
Increased Risk ◽  
Acute Exacerbations ◽  
Exacerbation Of Copd

Patients with chronic obstructive pulmonary disease (COPD) have a higher risk of acute cardiovascular events, and around 30% die from cardiovascular diseases. Recent data suggest an increased risk of myocardial infarction in the following days of a severe exacerbation of COPD. Disruption in the balance during the exacerbation with tachycardia, increased inflammation and systemic oxidative stress as well as some other factors may confer an increased risk of subsequent cardiovascular events. A number of investigations may be useful to an early diagnosis, including electrocardiography, imaging techniques and blood test for biomarkers. Some drugs that have changed prognosis in the cardiovascular setting such as cardioselective beta-blockers may be underused in patients with COPD despite its demonstrated benefits. This review focuses on several aspects of exacerbation of COPD and cardiovascular events including epidemiology, possible mechanism, diagnosis and treatment.

scholarly journals Possibilities and limitations of inhaled corticosteroids in the treatment of chronic obstructive pulmonary disease

2018 ◽  
Vol 28 (5) ◽  
pp. 602-612
Author(s):  
I. V. Leshchenko
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Inhaled Corticosteroids ◽  
Airflow Limitation ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
History Of ◽  
Long Acting ◽  
Exacerbation Of Copd

Combinations of inhaled corticosteroids (ICS) and long-acting bronchodilators are recommended for those patients with chronic obstructive pulmonary disease (COPD) who did not improve significantly with regular long-acting bronchodilators. ICS are known to increase the risk of pneumonia in elderly patients (over 55 years), current smokers, patients with acute exacerbation of COPD, patients with history of previous pneumonia, patients with body mass index < 25 kg/m2, and patients with dyspnea or severe airflow limitation. The risk-benefit ratio should be considered before initiating the treatment with ICS in COPD patients, particularly in patients with the risk factors of adverse events associated with ICS.

scholarly journals Acute Deterioration of an Intubated COPD Patient - A Case Report

2019 ◽  
pp. 1-5
Author(s):  
Chris Sarah Mathew ◽  
Edwin Dias
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Emergency Department ◽  
Intensive Care ◽  
Case Report ◽  
Clinical Course ◽  
Community Acquired Pneumonia ◽  
Chronic Obstructive ◽  
Unexpected Event ◽  
Obstructive Pulmonary Disease ◽  
Exacerbation Of Copd

Dealing with respiratory failure associated with exacerbation of chronic obstructive pulmonary disease (COPD) is not an uncommon scenario in intensive care units (ICUs). We present the case of an elderly man presenting to the emergency department (ED) with an infective exacerbation of COPD due to community acquired pneumonia. This case highlights an unexpected event following definitive airway management and its clinical course.

Role of exhaled nitric oxide in predicting steroid response in chronic obstructive pulmonary disease

2010 ◽  
Vol 151 (51) ◽  
pp. 2083-2088 ◽  
Author(s):  
Balázs Antus
Keyword(s):  
Nitric Oxide ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Exhaled Nitric Oxide ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Steroid Response

A kilégzett levegőben mérhető nitrogén-monoxid a legszélesebb körben vizsgált légúti biomarker. A stabil állapotú krónikus obstruktív tüdőbetegségben a kilégzett nitrogén-monoxid-szint hasonló vagy csak kismértékben emelkedett az egészségesekhez képest. Mivel a nitrogén-monoxid-szint szoros összefüggést mutat a légúti eosinophilia mértékével, és mivel az eosinophil típusú légúti gyulladás szteroidokra érzékenyebb, az emelkedett nitrogén-monoxid-szinttel rendelkező betegek jobb válaszkészséget mutatnak az inhalációs vagy szisztémás kortikoszteroidkezelésre. A krónikus obstruktív tüdőbetegség akut exacerbatiója során a kilégzett nitrogén-monoxid szintje megemelkedik, majd ennek kezelése után csökken. Mivel a nitrogén-monoxid-szint és a kezelés során elért légzésfunkciós javulás szoros korrelációt mutat egymással, a nitrogén-monoxid-méréssel a terápiás válasz megjósolható. Összefoglalva: a nitrogén-monoxid-méréssel a krónikus obstruktív tüdőbetegségben szenvedő betegek olyan alcsoportját lehet elkülöníteni, amelynek szteroidérzékenysége nagyobb. Orv. Hetil., 2010, 151, 2083–2088.

scholarly journals Validation of Clinical Characteristics and Effectiveness of Pulmonary Rehabilitation in a COPD Population with Discrepancy between Exercise Tolerance and FEV1

Healthcare ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 53
Author(s):  
Jun Horie ◽  
Koichiro Takahashi ◽  
Shuuichi Shiranita ◽  
Kunihiko Anami ◽  
Shinichiro Hayashi
Keyword(s):  
Gait Speed ◽  
Pulmonary Rehabilitation ◽  
Exercise Tolerance ◽  
Respiratory Illness ◽  
Forced Expiratory Volume ◽  
Walking Distance ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
St George's Respiratory Questionnaire ◽  
History Of

This study’s objective was to examine the characteristics of patients with chronic obstructive pulmonary disease (COPD) presenting with various exercise tolerance levels. A total of 235 patients with stable COPD were classified into 4 groups: (1) LoFlo + HiEx—patients with a six-minute walking distance (6MWD) ≥350 m and percentage of predicted forced expiratory volume in 1 s (%FEV1.0) <50%; (2) HiFlo + HiEx—patients with a 6MWD ≥350 m and a %FEV1.0 ≥50%; (3) LoFlo + LoEx—patients with a 6MWD < 350 m and %FEV1.0 < 50%; and (4) HiFlo + LoEx—patients with a 6MWD <350 m and %FEV1.0 ≥ 50%. Aspects of physical ability in the HiFlo + LoEx group were significantly lower than those in the HiFlo + HiEx group. The HiFlo + LoEx group was characterized by a history of hospitalization for respiratory illness within the past year, treatment with at-home oxygen therapy, and lacking daily exercise habits. Following three months of pulmonary rehabilitation, the LoFlo + HiEx group significantly improved in the modified Medical Research Council dyspnea score, maximum gait speed, and 6MWD, while the HiFlo + LoEx group significantly improved in the percentage of maximal expiratory pressure, maximum gait speed, 6MWD, incremental shuttle walking distance, and St. George’s Respiratory Questionnaire score. The HiFlo + LoEx group had the greatest effect of three-month pulmonary rehabilitation compared to other groups.

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