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Ventilation in COPD

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https://www.readbyqxmd.com/read/28528348/effect-of-home-noninvasive-ventilation-with-oxygen-therapy-vs-oxygen-therapy-alone-on-hospital-readmission-or-death-after-an-acute-copd-exacerbation-a-randomized-clinical-trial
#1
Patrick B Murphy, Sunita Rehal, Gill Arbane, Stephen Bourke, Peter M A Calverley, Angela M Crook, Lee Dowson, Nicholas Duffy, G John Gibson, Philip D Hughes, John R Hurst, Keir E Lewis, Rahul Mukherjee, Annabel Nickol, Nicholas Oscroft, Maxime Patout, Justin Pepperell, Ian Smith, John R Stradling, Jadwiga A Wedzicha, Michael I Polkey, Mark W Elliott, Nicholas Hart
Importance: Outcomes after exacerbations of chronic obstructive pulmonary disease (COPD) requiring acute noninvasive ventilation (NIV) are poor and there are few treatments to prevent hospital readmission and death. Objective: To investigate the effect of home NIV plus oxygen on time to readmission or death in patients with persistent hypercapnia after an acute COPD exacerbation. Design, Setting, and Participants: A randomized clinical trial of patients with persistent hypercapnia (Paco2 >53 mm Hg) 2 weeks to 4 weeks after resolution of respiratory acidemia, who were recruited from 13 UK centers between 2010 and 2015...
May 21, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28523018/effect-of-azithromycin-in-combination-with-simvastatin-in-the-treatment-of-chronic-obstructive-pulmonary-disease-complicated-by-pulmonary-arterial-hypertension
#2
Peidong Wang, Jie Yang, Yanwei Yang, Zhixin Ding
OBJECTIVE: To evaluate the effect of azithromycin in combination with simvastatin in the treatment of chronic obstructive pulmonary disease (COPD) complicated by pulmonary arterial hypertension. METHODS: Eighty-six patients who developed COPD and pulmonary arterial hypertension and received treatment from August 2013 to October 2014 were selected and randomly divided into an observation group and a control group using random number table, 43 in each group. Patients in the control group were orally administrated 20 mg of simvastatin, once a day...
March 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28511944/serum-periostin-in-patients-hospitalized-for-copd-exacerbations
#3
Elissavet Konstantelou, Andriana I Papaioannou, Stelios Loukides, Konstantinos Bartziokas, Anastasia Papaporfyriou, Georgios Papatheodorou, Petros Bakakos, Spyros Papiris, Nikolaos Koulouris, Konstantinos Kostikas
Serum periostin has been proposed as a surrogate biomarker of Th2 inflammatory response in patients with asthma, but its predictive role in hospitalized patients with COPD has not been evaluated. The aim of the present observational prospective cohort study was to evaluate the possible role of serum periostin as predictor of outcome in COPD patients hospitalized for AECOPD. Serum periostin was measured on admission and at discharge in patients admitted to the hospital for a COPD exacerbation. Patients were followed-up for 1year for future exacerbations, hospitalizations and mortality...
May 13, 2017: Cytokine
https://www.readbyqxmd.com/read/28506729/-the-role-of-extracorporeal-removal-of-co2-ecco2r-in-the-management-of-respiratory-diseases
#4
J L Diehl, J Boisramé-Helms, A Chardon-Couteau, M Commereuc, J-L Augy, A Sokoloff, N Rivet, P Gaussem, D M Smadja, N Aissaoui
INTRODUCTION: The aim of extracorporeal removal of CO2 (ECCO2R) is to ensure the removal of CO2 without any significant effect on oxygenation. ECCO2R makes use of low to moderate extracorporeal blood flow rates, whereas extracorporeal membrane oxygenation (ECMO) requires high blood flows. STATE OF THE ART: For each ECCO2R device it is important to consider not only performance in terms of CO2 removal, but also cost and safety, including the incidence of hemolysis and of hemorrhagic and thrombotic complications...
May 12, 2017: Revue des Maladies Respiratoires
https://www.readbyqxmd.com/read/28494170/why-high-intensity-nppv-is-favourable-to-low-intensity-nppv-clinical-and-physiological-reasons
#5
S B Schwarz, F S Magnet, W Windisch
High-intensity non-invasive positive pressure ventilation (NPPV) was originally described for chronic hypercapnic chronic obstructive pulmonary disease (COPD) patients in 2009, and refers to a specific ventilatory approach whereby NPPV settings are aimed at achieving the lowest arterial partial pressure of carbon dioxide (PaCO2) values possible. Thus, high-intensity NPPV requires ventilator settings to be increased in a stepwise approach to either an individually tolerated maximum, or to the levels necessary to achieve normocapnia...
May 11, 2017: COPD
https://www.readbyqxmd.com/read/28490871/home-noninvasive-positive-pressure-ventilation-with-built-in-software-in-stable-hypercapnic-copd-a-short-term-prospective-multicenter-randomized-controlled-trial
#6
Luqian Zhou, Xiaoying Li, Lili Guan, Jianhua Chen, Bingpeng Guo, Weiliang Wu, Yating Huo, Ziqing Zhou, Zhenyu Liang, Yuqi Zhou, Jie Tan, Xin Chen, Yuanlin Song, Rongchang Chen
BACKGROUND: The benefits of noninvasive positive pressure ventilation (NPPV) in patients with hypercapnic COPD are controversial. It is presumed that methodology and appropriate use of NIV ventilator might be crucial for the outcomes. With the new built-in software, the performance of NIV can be monitored at home, which can guarantee the compliance and appropriate use. This study investigated effects of home use of NIV in hypercapnia in COPD patients using the NIV ventilator with built-in software for monitoring...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28490869/pulmonary-infection-control-window-as-a-switching-point-for-sequential-ventilation-in-the-treatment-of-copd-patients-a-meta-analysis
#7
Yingying Lv, Qiurong Lv, Quanchao Lv, Tianwen Lai
PURPOSE: Choosing the appropriate time to switch to noninvasive positive-pressure ventilation (NPPV) plays a crucial role in promoting successful weaning. However, optimal timing for transitioning and weaning patients from mechanical ventilation (MV) to NPPV has not been clearly established. In China, the pulmonary infection control (PIC) window as a switching point for weaning from MV has been performed for many years, without definitive evidence of clinical benefit. This study aimed to summarize the evidence for NPPV at the PIC window for patients with respiratory failure from COPD...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28485989/non-invasive-positive-airway-pressure-in-obesity-hypoventilation-syndrome-and-chronic-obstructive-pulmonary-disease-present-and-future-perspectives
#8
Victor R Ramírez-Molina, Francisco J Gómez-de-Terreros, Javier Barca-Durán, Juan F Masa
Obesity hypoventilation syndrome (OHS) is a sleep disorder that has acquired great importance worldwide because of its prevalence and association with obesity leading to increased morbidity and mortality with reduced quality of life. The primary feature is insufficient sleep-related ventilation, resulting in abnormally elevated arterial carbon dioxide pressure (PaCO2) during sleep and demonstration of daytime hypoventilation. There are three main mechanisms that can generate diurnal hypoventilation in obese patients: alteration of the respiratory mechanics secondary to obesity; central hypoventilation secondary to leptin resistance and sleep disorder with sleep hypoventilation and obstructive apnoeas, which can be potentially solved with the use of positive airway pressure: non-invasive ventilation (NIV) and continuous positive airway pressure (CPAP)...
May 9, 2017: COPD
https://www.readbyqxmd.com/read/28482421/-effect-of-home-noninvasive-positive-pressure-ventilation-on-patients-with-severe-stable-chronic-obstructive-pulmonary-disease-a-meta-analysis
#9
Y Liu, B Dai, J Su, Y Peng, W Tan, H W Zhao
Objective: To evaluate the effect of home noninvasive positive pressure ventilation (NPPV) on patients with severe stable chronic obstructive pulmonary disease(COPD) by meta-analysis. Methods: The data of this meta-analysis was retrieved from the PubMed, EMBASE, Cochrane library, Wanfang, Weipu and CNKI databases from January 1980 to January 2016. Randomized controlled trials (RCTs) on comparison of the effect of home NPPV in patients with severe stable COPD were enrolled. The enrolled data were divided into different subgroups in terms of the levels of inspiratory positive airway pressure(IPAP), different duration of ventilation per day, and different levels of baseline hypercapnia on change in PaCO(2)...
May 12, 2017: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/28464911/impact-of-high-intensity-niv-on-the-heart-in-stable-copd-a-randomised-cross-over-pilot-study
#10
Marieke Leontine Duiverman, Petra Maagh, Friederike Sophie Magnet, Claudia Schmoor, Maria Paola Arellano-Maric, Axel Meissner, Jan Hendrik Storre, Peter Jan Wijkstra, Wolfram Windisch, Jens Callegari
BACKGROUND: Although high-intensity non-invasive ventilation has been shown to improve outcomes in stable COPD, it may adversely affect cardiac performance. Therefore, the aims of the present pilot study were to compare cardiac and pulmonary effects of 6 weeks of low-intensity non-invasive ventilation and 6 weeks of high-intensity non-invasive ventilation in stable COPD patients. METHODS: In a randomised crossover pilot feasibility study, the change in cardiac output after 6 weeks of each NIV mode compared to baseline was assessed with echocardiography in 14 severe stable COPD patients...
May 2, 2017: Respiratory Research
https://www.readbyqxmd.com/read/28464807/prognostic-factors-in-hospitalized-community-acquired-pneumonia-a-retrospective-study-of-a-prospective-observational-cohort
#11
Akihiro Ito, Tadashi Ishida, Hironobu Tokumasu, Yasuyoshi Washio, Akio Yamazaki, Yuhei Ito, Hiromasa Tachibana
BACKGROUND: To date, only few studies have examined the prognostic factors of community-acquired pneumonia (CAP) defined according to the latest criteria, which excludes healthcare-associated pneumonia (HCAP). Therefore, we aimed to investigate the factors that affect prognosis, and evaluate the usefulness of existing pneumonia severity scores for predicting the prognosis of CAP. METHODS: We retrospectively analyzed patients with CAP, excluding HCAP, who were enrolled prospectively between April 2007 and February 2016...
May 2, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28461746/copd-is-a-clear-risk-factor-for-increased-use-of-resources-and-adverse-outcomes-in-patients-undergoing-intervention-for-colorectal-cancer-a-nationwide-study-in-spain
#12
Marisa Baré, Concepción Montón, Laura Mora, Maximino Redondo, Marina Pont, Antonio Escobar, Cristina Sarasqueta, Nerea Fernández de Larrea, Eduardo Briones, Jose Maria Quintana
BACKGROUND: We hypothesized that patients undergoing surgery for colorectal cancer (CRC) with COPD as a comorbidity would consume more resources and have worse in-hospital outcomes than similar patients without COPD. Therefore, we compared different aspects of the care process and short-term outcomes in patients undergoing surgery for CRC, with and without COPD. METHODS: This was a prospective study and it included patients from 22 hospitals located in Spain - 472 patients with COPD and 2,276 patients without COPD undergoing surgery for CRC...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28460826/pulmonary-function-after-lung-tumor-stereotactic-ablative-radiotherapy-depends-on-regional-ventilation-within-irradiated-lung
#13
Michael S Binkley, Martin T King, Joseph B Shrager, Karl Bush, Aadel A Chaudhuri, Rita Popat, Michael F Gensheimer, Peter G Maxim, H Henry Guo, Maximilian Diehn, Viswam S Nair, Billy W Loo
PURPOSE: To determine if regional ventilation within irradiated lung volume predicts change in pulmonary function test (PFT) measurements after stereotactic ablative radiotherapy (SABR) of lung tumors. METHODS: We retrospectively identified 27 patients treated from 2007 to 2014 at our institution who received: (1) SABR without prior thoracic radiation; (2) pre-treatment 4-dimensional computed tomography (4-D CT) imaging; (3) pre- and post-SABR PFTs <15months from treatment...
May 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28458528/significance-of-nt-pro-bnp-in-acute-exacerbation-of-copd-patients-without-underlying-left-ventricular-dysfunction
#14
Muhammad Adrish, Varalaxmi Bhavani Nannaka, Edison J Cano, Bharat Bajantri, Gilda Diaz-Fuentes
BACKGROUND: B-type natriuretic peptide (BNP) and the N-terminal fragment of pro-BNP (NT-pro-BNP) are established biomarkers of heart failure. Increased levels of natriuretic peptide (NP) have been associated with poor outcomes in acute exacerbation of COPD (AECOPD); however, most studies did not address the conditions that can also increase NT-pro-BNP levels. We aimed to determine if NT-pro-BNP levels correlate with outcomes of AECOPD in patients without heart failure and other conditions that can affect NT-pro-BNP levels...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28453306/the-association-of-lung-clearance-index-with-copd-and-fev-1-reduction-in-men-born-in-1914
#15
Suneela Zaigham, Per Wollmer, Gunnar Engström
Lung Clearance Index (LCI) provides an overall measurement of ventilation inhomogeneity. This population-based study examines whether LCI predicts pulmonary obstruction and incidence of chronic obstructive pulmonary disease (COPD) events over a long-term follow-up. Multiple breath nitrogen washout and spirometry were performed in 674 men from the cohort "Men born in 1914" at age 55 years. Subjects were classified into quartiles (Q) of LCI and according to LCI above and below upper limit of normal (ULN). Incidence of COPD events (COPD hospitalisations or COPD-related deaths) were monitored over the remaining life span of the men, by linkage with national hospital registers...
April 28, 2017: COPD
https://www.readbyqxmd.com/read/28449471/one-year-and-long-term-mortality-in-patients-hospitalized-for-chronic-obstructive-pulmonary-disease
#16
María-Teresa García-Sanz, Juan-Carlos Cánive-Gómez, Laura Senín-Rial, Jorge Aboal-Viñas, Alejandra Barreiro-García, Eva López-Val, Francisco-Javier González-Barcala
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality worldwide. Identifying potentially-modifiable predictors of mortality could help optimize COPD patient management. The aim of this study is to determine long-term mortality following hospitalization due to acute exacerbations of COPD (AECOPD), as well as AECOPD mortality predictors. METHODS: We conducted a retrospective study by reviewing the medical records of all patients admitted with AECOPD in the University Hospital Complex of Santiago de Compostela in 2007 and 2008...
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28435239/pulmonary-rehabilitation-for-copd-improves-exercise-time-rather-than-exercise-tolerance-effects-and-mechanisms
#17
Keisuke Miki, Ryoji Maekura, Seigo Kitada, Mari Miki, Kenji Yoshimura, Hiroshi Yamamoto, Toshiko Kawabe, Hiroyuki Kagawa, Yohei Oshitani, Akitoshi Satomi, Kohei Nishida, Nobuhiko Sawa, Kimiko Inoue
BACKGROUND: COPD patients undergoing pulmonary rehabilitation (PR) show various responses. The purpose of this study was to investigate the possible mechanisms and predictors of the response to PR in COPD patients. METHODS: Thirty-six stable COPD patients underwent PR including a 4-week high-intensity exercise training program, and they were evaluated by cardiopulmonary exercise testing. All patients (mean age 69 years, severe and very severe COPD 94%) were classified into four groups by whether the exercise time (Tex) or the peak oxygen uptake [Formula: see text] increased after PR: two factors increased (both the Tex and the peak [Formula: see text] increased); two factors decreased; time only increased (the Tex increased, but the peak [Formula: see text] economized); and [Formula: see text] only increased (the Tex decreased, but the peak [Formula: see text] increased)...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28423189/computed-tomography-quantification-of-tracheal-abnormalities-in-copd-and-their-influence-on-airflow-limitation
#18
Leticia Gallardo Estrella, Esther Pompe, Jan-Martin Kuhnigk, David A Lynch, Surya P Bhatt, Bram van Ginneken, Eva Marjolein van Rikxoort
PURPOSE: To present a method to automatically quantify tracheal morphology changes during breathing and investigate its contribution to airflow impairment when adding CT measures of emphysema, airway wall thickness, air trapping and ventilation. METHODS: Because tracheal abnormalities often occur localized, a method is presented that automatically determines the most abnormal trachea section based on automatically computed sagittal and coronal lengths. In this most abnormal section, trachea morphology is encoded using four equiangular rays from the center of the trachea and the normalized lengths of these rays are used as features in a classification scheme...
April 17, 2017: Medical Physics
https://www.readbyqxmd.com/read/28422346/does-limb-partitioning-and-positioning-affect-acute-cardiorespiratory-responses-during-strength-exercises-in-patients-with-copd
#19
Priscila Robles, Tamara Araujo, Dina Brooks, Karl Zabjek, Tania Janaudis-Ferreira, Susan Marzolini, Roger Goldstein, Sunita Mathur
BACKGROUND AND OBJECTIVE: Cardiorespiratory responses and symptoms in response to endurance exercise in patients with COPD vary with the number and position of involved limbs. Responses to such variations have never been quantified for strength exercises. We therefore assessed acute cardiorespiratory responses during brief bouts of weight lifting exercises. METHODS: We compared double- versus single-limb leg extensions and arm elevations, as well as arm elevation done above or below shoulder level in patients with moderate to severe COPD (n = 10, 6 males, 66 (8...
April 19, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28413497/antibiotic-de-escalation-principle-in-elderly-patients-with-chronic-obstructive-pulmonary-disease-complicated-with-severe-pneumonia
#20
Baohong Xiao, Mei Wang, Xiaoling Hu, Jinfeng Li, Fangfang Wang, Jiaxing Sun
The present study investigated the clinical effect of antibiotic de-escalation therapy in elderly patients with chronic obstructive pulmonary disease (COPD) complicated with severe pneumonia. According to the parity method of hospitalization number, 86 cases were selected and divided into the observation and control group with 43 cases each. Based on empirical antibiotic application, levofloxacin and cephalosporin antibiotics were used in the control group. After treatment for 3 days, the regimen was adjusted to antibiotics active against Gram-positive (G+) and Gram-negative (G-) bacteria such as the third or fourth generation cephalosporin antibiotics, combined with aminoglycoside, or macrolide antibiotics according to their effects...
April 2017: Experimental and Therapeutic Medicine
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