scholarly journals P7‐42: Significance of monitoring patients with chronic obstructive pulmonary disease during walking rehabilitation by transcutaneous blood gas analysis

Respirology ◽  
2021 ◽  
Vol 26 (S3) ◽  
pp. 275-275
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Chronic Obstructive ◽  
Blood Gas ◽  
Obstructive Pulmonary Disease ◽  
Walking Rehabilitation

scholarly journals Analysis of the characteristics of patients admitted to Internal Medicine wards for exacerbation of chronic obstructive pulmonary disease, and discharge phase optimization. The SDO-ARCA Project of the Scientific Society FADOI

2020 ◽  
Vol 14 (3) ◽  
pp. 156-161
Author(s):  
Marco Candela ◽  
Claudio Norbiato ◽  
Mauro Campanini ◽  
Antonio Luca Brucato ◽  
Salvatore Di Simone ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Chronic Obstructive ◽  
Post Discharge ◽  
Obstructive Pulmonary Disease ◽  
Exacerbation Of Copd ◽  
A Prospective Study

The purpose of this study was to have a nationwide snapshot of the characteristics of patients hospitalized in Internal Medicine Units (IMUs) for exacerbation of chronic obstructive pulmonary disease (COPD), and to assess applicability and contents of a specific Hospital Discharge Form for the patient with exacerbation of COPD discharged from IMUs. This was a prospective study in 44 IMUs in Italy, enrolling patients hospitalized with a diagnosis of COPD exacerbation. Information concerning clinical characteristics of patients, and treatment for COPD at discharge was collected. Specific documents for monitoring of clinical conditions and adherence to therapies as well as a form including individual indications for clinical controls, instrumental tests, etc. were provided upon discharge. Four hundred and seventy-two patients were enrolled (68% male). According to GOLD classification 2015, patients with classes A to D were 12%, 27%, 31%, and 30%, respectively. Triple therapy was prescribed in 14% of GOLD A and 51% of GOLD D patients. Around 10% of patients for each GOLD class received no specific therapy. The vast majority of patients (85%) received instructions on the correct use of inhalers, and in most cases (85%), the quality of counseling was considered optimal/adequate. Indication for performing chest X-ray, spirometry, or blood gas analysis following discharge was addressed to 29%, 59% and 52.1% of patients, respectively. The follow-up sheet for COPD used in our study was shown as applicable. This highlighted the need for greater awareness and more standardized procedures within IMUs in the post-discharge phase.

scholarly journals Identifying the most effective tool to assess health status of patients with acute exacerbation of chronic obstructive pulmonary disease -a prospective study

2019 ◽  
Author(s):  
ping chen ◽  
Aiyuan Zhou ◽  
Zijing Zhou ◽  
Dingding Deng ◽  
Yiyang Zhao ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Health Status ◽  
Lung Function ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Chronic Obstructive ◽  
Blood Gas ◽  
Obstructive Pulmonary Disease ◽  
Reported Health ◽  
Self Reported Health Status

Abstract Background: There is currently no recognized discharge criteria for patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). In clinical work, pulmonologists determine whether a patient can be discharged considering the patient self-reported health status and some measurements which are related to the health status of AECOPD patients. Various measurements have been used to evaluate health status in patients with AECOPD, including lung function, fractional exhaled nitric oxide (FENO), blood gas analysis, COPD Assessment Test (CAT) and modified Medical Research Council test (mMRC). However, which one is most closely related to the patient self-reported health status remains unknown. Methods: Patients with AECOPD were assessed at two visits: on admission and on day 7. The above measurements were tested at each visit. At the second visit, the patients were asked to report the health status according to a five-point Likert scale ranging from 1 to 5, representing ‘much better’, ‘slightly better’, ‘no change’, ‘slightly worse’ and ‘much worse’. Based on patients self-reported outcome, we defined the responders as those patients who reported “much better,” or “slightly better”, non-responders were those who reported ‘no change,’ ‘slightly worse’ or ‘much worse’. Results: 55 patients were recruited into analysis. FENO and CAT could change sensitively based on different health status, except failing to differentiate the patients between those who reported ‘slightly better’ and ‘no changes’. The changes in predicted percentage of forced expiratory volume in 1 s (FEV1%) didn’t change significantly between ‘no change’ group and ‘slightly better or much better’ group, it could only identify the ‘slightly worse’ patients. Although mMRC and blood gas analysis (PaO2, PaCO2) changed significantly after treatment, they didn’t reflect sensitively the evolution of health status. Among these measurements, the changes in CAT was best correlated with the evolution of health status (Rho=0.81), followed by FENO and FEV1%, the rho was 0.59 and -0.42, respectively. Conclusion: It’s reasonable to monitor CAT and FENO during exacerbation stage, the use of lung function and mMRC to evaluate the evolution of patients’ reported health status of patients with AECOPD is limited. Registry number: ChiCTR-ROC-16009087 (http://www.chictr.org.cn/).

Pulmonary Function after Emergence on 100% Oxygen in Patients with Chronic Obstructive Pulmonary Disease

2014 ◽  
Vol 120 (5) ◽  
pp. 1146-1151 ◽  
Author(s):  
Axel T. Kleinsasser ◽  
Iris Pircher ◽  
Suzan Truebsbach ◽  
Hans Knotzer ◽  
Alexander Loeckinger ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Blood Flow ◽  
Partial Pressure ◽  
Pulmonary Disease ◽  
Pulmonary Blood Flow ◽  
Chronic Obstructive ◽  
Blood Gas ◽  
Obstructive Pulmonary Disease ◽  
Arterial Partial Pressure ◽  
Oxygen Breathing

Abstract Background: During emergence from anesthesia, breathing 100% oxygen is frequently used to provide a safety margin toward hypoxemia in case an airway problem occurs. Oxygen breathing has been shown to cause pulmonary gas exchange disorders in healthy individuals. This study investigates how oxygen breathing during emergence affects lung function specifically whether oxygen breathing causes added hypoxemia in patients with chronic obstructive pulmonary disease. Methods: This trial has been conducted in a parallel-arm, case-controlled, open-label manner. Fifty-three patients with chronic obstructive pulmonary disease were randomly allocated (computer-generated lists) to breathe either 100 or 30% oxygen balanced with nitrogen during emergence from anesthesia. Arterial blood gas measurements were taken before induction and at 5, 15, and 60 min after extubation. Results: All participants tolerated the study well. Patients treated with 100% oxygen had a higher alveolar–arterial oxygen pressure gradient (primary outcome) compared with patients treated with 30% oxygen (25 vs. 20 mmHg) and compared with their baseline at the 60-min measurement (25 vs. 17 mmHg). At the 60-min measurement, arterial partial pressure of oxygen was lower in the 100% group (62 vs. 67 mmHg). Arterial partial pressure of carbon dioxide and pH were not different between groups or measurements. Conclusions: In this experiment, the authors examined oxygen breathing during emergence—a widely practiced maneuver known to generate pulmonary blood flow heterogeneity. In the observed cohort of patients already presenting with pulmonary blood flow disturbances, emergence on oxygen resulted in deterioration of oxygen-related blood gas parameters. In the perioperative care of patients with chronic obstructive pulmonary disease, oxygen breathing during emergence from anesthesia may need reconsideration.

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