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Ventilation in COPD

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https://www.readbyqxmd.com/read/28435239/pulmonary-rehabilitation-for-copd-improves-exercise-time-rather-than-exercise-tolerance-effects-and-mechanisms
#1
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
#2
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
#3
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
#4
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
https://www.readbyqxmd.com/read/28408814/non-invasive-ventilation-with-intelligent-volume-assured-pressure-support-versus-pressure-controlled-ventilation-effects-on-the-respiratory-event-rate-and-sleep-quality-in-copd-with-chronic-hypercapnia
#5
Georg Nilius, Nato Katamadze, Ulrike Domanski, Maik Schroeder, Karl-Josef Franke
BACKGROUND: COPD patients who develop chronic hypercapnic respiratory failure have a poor prognosis. Treatment of choice, especially the best form of ventilation, is not well known. OBJECTIVES: This study compared the effects of pressure-controlled (spontaneous timed [ST]) non-invasive ventilation (NIV) and NIV with intelligent volume-assured pressure support (IVAPS) in chronic hypercapnic COPD patients regarding the effects on alveolar ventilation, adverse patient/ventilator interactions and sleep quality...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28402093/extracorporeal-co2-removal-ecco2r-in-critically-ill-patients-a-systematic-review
#6
Fabio S Taccone, Maximilian V Malfertheiner, Fiorenza Ferrari, Matteo DI Nardo, Justyna Swol, Lars M Broman, Leen Vercaemst, Nicholas Barrett, Federico Pappalardo, Jan Belohlavek, Thomas Mueller, Roberto Lorusso, Mirko Belliato
INTRODUCTION: The use of extracorporeal CO2 removal (ECCO2R) is increasingly employed in critically ill patients. However, the clinical evidence supporting its efficacy remains currently poor. EVIDENCE ACQUISITION: A systematic review using MEDLINE via PubMed was performed to identify eligible studies (until 30th September 2016). The amount of CO2 reduction, the effect on the duration of mechanical ventilation and weaning, the impact on patients' outcome and the occurrence of complications were evaluated...
April 11, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28401600/involvement-of-patients-perspectives-on-treatment-with-non-invasive-ventilation-in-patients-with-copd-a-qualitative-study
#7
Helle Marie Christensen, Lotte Huniche, Ingrid L Titlestad
AIMS AND OBJECTIVES: To clarify COPD patients' perspectives on treatment with non-invasive ventilation and develop management strategies for the treatment based on these perspectives. BACKGROUND: The effect of treating COPD patients with non-invasive ventilation is well documented, as is the problem of patient difficulties in tolerating the treatment. Knowledge of how patients with COPD experience and evaluate treatment with non-invasive ventilation is limited; therefore, more information of patient perspectives is needed to develop treatment practices in respiratory medicine...
April 12, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28394653/in-vitro-in-vivo-comparison-of-inhaled-salbutamol-dose-delivered-by-jet-nebulizer-vibrating-mesh-nebulizer-and-metered-dose-inhaler-with-spacer-during-non-invasive-ventilation
#8
Ahmed Hassan, Randa Salah Eldin, Maha M Abdelrahman, Mohamed E Abdelrahim
BACKGROUND: Patients receiving noninvasive ventilation (NIV) may benefit from medical aerosol, but most guidance on dosing with different aerosol devices is limited to in-vitro studies. The study was designed to in-vitro, ex-vivo, and in-vivo compare aerosol delivery during bilevel NIV with three types of aerosol generators: metered dose inhaler with AeroChamber-MV spacer (AC), Aerogen Pro vibrating mesh nebulizer (PRO), and Sidestream jet nebulizer (SIDE). MATERIALS AND METHOD: A bilevel ventilator with dry single limb circuit and fixed expiratory port was set in spontaneous mode with initial inspiratory and expiratory pressures of 20 and 5 cmH20, 1:3 inspiratory-expiratory ratio, and 15 breaths...
February 2017: Experimental Lung Research
https://www.readbyqxmd.com/read/28392039/effect-of-arterial-puncture-on-ventilation
#9
Ashima Synghal Sahni, Hemil Gonzalez, Aiman Tulaimat
BACKGROUND: Clinicians frequently assume that during arterial puncture for measuring arterial blood gases patients hyperventilate from pain and anxiety. This assumption leads clinicians to falsely interpret a PaCO2 and pH near the upper limit of normal as a chronic respiratory acidosis corrected by an acute respiratory alkalosis. OBJECTIVE: Determine if participants hyperventilate during arterial puncture from pain and anxiety. METHODS: We recruited participants from a pulmonary function laboratory referred for arterial blood gas measurement...
April 6, 2017: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/28388225/effects-of-pressure-support-ventilation-may-be-lost-at-high-exercise-intensities-in-people-with-copd
#10
David Anekwe, Michel de Marchie, Jadranka Spahija
Pressure support ventilation (PSV) may be used for exercise training in chronic obstructive pulmonary disease (COPD), but its acute effect on maximum exercise capacity is not fully known. The objective of this study was to evaluate the effect of 10 cm H2O PSV and a fixed PSV level titrated to patient comfort at rest on maximum exercise workload (WLmax), breathing pattern and metabolic parameters during a symptom-limited incremental bicycle test in individuals with COPD. Eleven individuals with COPD (forced expiratory volume in one second: 49 ± 16%; age: 64 ± 7 years) performed three exercise tests: without a ventilator, with 10 cm H2O of PSV and with a fixed level titrated to comfort at rest, using a SERVO-i ventilator...
April 7, 2017: COPD
https://www.readbyqxmd.com/read/28351903/diaphragm-muscle-thinning-in-subjects-receiving-mechanical-ventilation-and-its-effect-on-extubation
#11
Horiana B Grosu, David E Ost, Young Im Lee, Juhee Song, Liang Li, Edward Eden, Keith Rose
BACKGROUND: Diaphragm muscle weakness and atrophy are consequences of prolonged mechanical ventilation. Our purpose was to determine whether thickness of the diaphragm (TDI) changes over time after intubation and whether the degree of change affects clinical outcome. METHODS: For this prospective, longitudinal observational study, we identified subjects who required mechanical ventilation and measured their TDI by ultrasonography. TDI was measured at baseline and repeated 72 h later and then weekly until the subject was either liberated from mechanical ventilation, was referred for tracheostomy, or died...
March 28, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28345959/ventilatory-inefficiency-and-exertional-dyspnea-in-early-chronic-obstructive-pulmonary-disease
#12
J Alberto Neder, Danilo C Berton, Paulo de Tarso Müller, Amany F Elbehairy, Alcides Rocha, Paolo Palange, Denis E O'Donnell
Exertional dyspnea is present across the spectrum of chronic obstructive pulmonary disease (COPD) severity. However, without realizing it themselves, patients may decrease daily physical activity to avoid distressing respiratory sensations. Dyspnea also may be associated with deconditioning. Cardiopulmonary exercise testing can uncover exertional dyspnea and its physiological determinants in patients with preserved or only mildly-reduced FEV1. Dyspnea in mild COPD can largely be explained by increased "wasted" ventilation in the physiological dead space which heightens the drive to breathe and worsens the inspiratory mechanical constraints...
March 27, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28340860/association-of-pre-hospital-theophylline-use-and-mortality-in-chronic-obstructive-pulmonary-disease-patients-with-sepsis
#13
Yu-Ning Shih, Yung-Tai Chen, Hsi Chu, Chia-Jen Shih, Shuo-Ming Ou, Yen-Tao Hsu, Ran-Chou Chen, Sadeq A Quraishi, Imoigele P Aisiku, Raghu R Seethala, Gyorgy Frendl, Peter C Hou
BACKGROUND: Although theophylline has been shown to have anti-inflammatory effects, the therapeutic use of theophylline before sepsis is unknown. The aim of our study was to determine the effect of theophylline on COPD patients presenting with sepsis. METHODS: This nationwide, population-based, propensity score-matched analysis used data from the linked administrative databases of Taiwan's National Health Insurance program. Patients with COPD who were hospitalized for sepsis between 2000 and 2011 were divided into theophylline users and non-users...
April 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28339316/practical-insight-to-monitor-home-niv-in-copd-patients
#14
Jean-Michel Arnal, Joëlle Texereau, Aude Garnero
Home noninvasive ventilation (NIV) is used in COPD patients with concomitant chronic hypercapnic respiratory failure in order to correct nocturnal hypoventilation and improve sleep quality, quality of life, and survival. Monitoring of home NIV is needed to assess the effectiveness of ventilation and adherence to therapy, resolve potential adverse effects, reinforce patient knowledge, provide maintenance of the equipment, and readjust the ventilator settings according to the changing condition of the patient...
March 24, 2017: COPD
https://www.readbyqxmd.com/read/28339309/the-use-of-non-invasive-ventilation-during-exercise-training-in-copd-patients
#15
Nicolino Ambrosino, Lixin Xie
Non-invasive ventilation (NIV) is increasingly used in addition to exercise training in patients with chronic obstructive pulmonary disease with the purpose to allow them to train at higher intensities. Different modalities of assisted ventilation have been used with benefits for relief of dyspnoea and increase in exercise capacity. Nevertheless there are some potential problems with the use of NIV in pulmonary rehabilitation programmes. Despite promising results, a generalised use of NIV during exercise training programmes is unlikely to have a role in routine settings...
March 24, 2017: COPD
https://www.readbyqxmd.com/read/28338298/tidal-airway-closure-in-asthma-and-copd
#16
Claudio Tantucci, Laura Pini
Functional closure of small airways can occur during tidal breathing above functional residual capacity (FRC) both in asthma and COPD patients, especially during exacerbations. Such event has several noxious consequences on gas exchange, airway hyperresponsiveness and mechanical stress and strain within lung tissue and airway wall, mostly due to increase in ventilation heterogeneity. The availability of simple functional tests based on sequential measurements of lung volumes (i.e.: FRC), by plethysmography and dilutional techniques may reveal and monitor easily tidal airway closure that can be and should be treated with the aim of abolishing or at least reducing this dangerous condition...
November 23, 2016: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/28326310/cardiopulmonary-response-during-whole-body-vibration-training-in-patients-with-severe-copd
#17
Rainer Gloeckl, Petra Richter, Sandra Winterkamp, Michael Pfeifer, Christoph Nell, Jeffrey W Christle, Klaus Kenn
Several studies in patients with chronic obstructive pulmonary disease (COPD) have shown that whole-body vibration training (WBVT) has beneficial effects on exercise capacity. However, the acute cardiopulmonary demand during WBVT remains unknown and was therefore investigated in this study. Ten patients with severe COPD (forced expiratory volume in 1 s: 38±8% predicted) were examined on two consecutive days. On day one, symptom-limited cardiopulmonary exercise testing was performed on a cycle ergometer. The next day, six bouts of repeated squat exercises were performed in random order for one, two or three minutes either with or without WBVT while metabolic demands were simultaneously measured...
January 2017: ERJ Open Research
https://www.readbyqxmd.com/read/28325021/evaluation-of-lung-ventilation-distribution-in-chronic-obstructive-pulmonary-disease-patients-using-the-global-inhomogeneity-index
#18
F Trenk, L Mendes, P Carvalho, R P Paiva, J Henriques, N Maglaveras, I Chouvarda, V Tsara, C A Teixeira
The global inhomogeneity (GI) index is a electrical impedance tomography (EIT) parameter that quantifies the tidal volume distribution within the lung. In this work the global inhomogeneity index was computed for twenty subjects in order to evaluate his potential use in the detection and follow up of chronic obstructive pulmonary disease (COPD) patients. EIT data of 17 subjects were acquired: 14 patients with the main diagnoses of COPD and 3 healthy subjects which served as a control group. Two or three datasets of around 30 seconds were acquired at 33 scans/s and analysed for each subject...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28318340/characteristic-plethysmographic-findings-in-a-guinea-pig-model-of-copd
#19
Edgar Ramírez-Ramírez, Armando Torres-Ramírez, Jesús Alquicira-Mireles, Abraham Cañavera-Constantino, Patricia Segura-Medina, Martha Montaño-Ramírez, Carlos Ramos-Abraham, Mario H Vargas, José Luis Arreola-Ramírez
AIM OF THE STUDY: Long-term exposure to cigarette smoke generates chronic obstructive pulmonary disease (COPD) in guinea pigs, but a comprehensive evaluation of changes in lung function, as assessed by barometric whole body plethysmography (WBP), is lacking. MATERIALS AND METHODS: Female guinea pigs were exposed to the smoke of 20 cigarettes/day, 5 days/week, during 10 weeks (COPD group, n = 8), and were compared with unexposed female guinea pigs of the same age (control group, n = 8)...
March 20, 2017: Experimental Lung Research
https://www.readbyqxmd.com/read/28298398/management-of-copd-exacerbations-a%C3%A2-european-respiratory-society-american-thoracic-society-guideline
#20
Jadwiga A Wedzicha, Marc Miravitlles, John R Hurst, Peter M A Calverley, Richard K Albert, Antonio Anzueto, Gerard J Criner, Alberto Papi, Klaus F Rabe, David Rigau, Pawel Sliwinski, Thomy Tonia, Jørgen Vestbo, Kevin C Wilson, Jerry A Krishnan
This document provides clinical recommendations for treatment of chronic obstructive pulmonary disease (COPD) exacerbations.Comprehensive evidence syntheses, including meta-analyses, were performed to summarise all available evidence relevant to the Task Force's questions. The evidence was appraised using the Grading of Recommendations, Assessment, Development and Evaluation approach and the results were summarised in evidence profiles. The evidence syntheses were discussed and recommendations formulated by a multidisciplinary Task Force of COPD experts...
March 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
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