scholarly journals Spirometric Predictors for the Exclusion of Severe Hypoxemia in Chronic Obstructive Pulmonary Disease

2001 ◽  
Vol 8 (4) ◽  
pp. 245-249 ◽  
Author(s):  
Hakan Gunen ◽  
Feridun Kosar
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Arterial Oxygen ◽  
Chronic Obstructive ◽  
Severe Hypoxemia ◽  
Obstructive Pulmonary Disease ◽  
Predictive Values ◽  
Mean Values ◽  
Arterial Blood ◽  
The Mean

BACKGROUND: Controversy has existed over the need for routine arterial blood gas (ABG) analysis in patients with chronic obstructive pulmonary disease (COPD). Some authors recommend it in all patients with COPD, but others find it unnecessary if the forced expiratory volume in 1 s (FEV1) is 50% of predicted or greater.OBJECTIVES: To clarify this controversy, and to investigate correlations between severe hypoxemia and multiple spirometric parameters in patients with COPD with FEV150% of predicted or greater.PATIENTS AND METHODS: In 103 consecutive patients with COPD with FEV150% of predicted or greater, and without any other cardiopulmonary disorder, the incidence of severe hypoxemia (partial pressure of arterial oxygen less than 60 mmHg) was established by ABG analysis. Positive and negative predictive values (PPVs and NPVs, respectively) for severe hypoxemia for multiple spirometric parameters (FEV1, FEV1/forced vital capacity [FVC], peak expiratory flow [PEF], maximal midexpiratory flow rate [FEF25-75]) were evaluated in a stepwise manner.RESULTS: Twenty-two patients (21%) were found to be severely hypoxemic. In the severely hypoxemic group, the mean values for FEV1, FEV1/FVC, PEF and FEF25-75were 59.0±8.19%, 53.6±11.3, 50.6±9.3 and 34.4±14.2% of predicted, respectively. The mean values for the same parameters in the other patients were 58.0±4.6%, 52.7±7.8, 51.5±7.5 and 39.1±7.7% of predicted, respectively. Comparing these parameters between the two groups, only the difference in FEF25-75was statistically significant (P<0.01). Valid PPVs and NPVs could not be established for any of the parameters at any level, except for the NPV for FEF25-7550% of predicted or greater, which was 92%. This threshold value resulted in a false negative finding in less than 5% of the patients with hypoxemia.CONCLUSIONS: The results of the present study showed that one in five patients with COPD with FEV150% of predicted or greater was severely hypoxemic. In such patients, hypoxemia may be excluded, and ABG analysis may not be needed when the FEF25-75is also 50% of predicted or greater. The FEV1, FEV1/FVC and PEF parameters failed to predict or exclude severe hypoxemia.

scholarly journals DIAGNOSTIC CAPABILITIES OF DIGITAL FLUOROGRAPHY IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

2015 ◽  
Vol 14 (1) ◽  
pp. 24-31
Author(s):  
N. A. Gorbunov ◽  
A. P. Dergilev ◽  
L. D. Sidorova ◽  
V. I. Kochura
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Optical Density ◽  
Stage I ◽  
Chronic Obstructive ◽  
Forced Expiration ◽  
Obstructive Pulmonary Disease ◽  
Mean Values ◽  
Digital Chest ◽  
The Mean

The purpose of the study – to examine the capabilities of the method of digital chest fluorography in diagnosis of chronic obstructive pulmonary disease (COPD) of different stages. By chest digital fluorography 247 patients with clinically diagnosed COPD stage I–III were examined. The average age of the patients was (55.3  1.7) years (16 to 88 years), forced expiration volume for the first second (FEV1) was (59.17  16.28) %. It was shown that for patients with COPD stage I most characteristic radiographic symptom was emphysema of the lung in the upper regions (26 (48%) of 54 patients); the mean values of the inspiratory lung optical density (ILOD) ranged from (703.48  2.15) to (807.47  5.61) optical density units (ODU), the expiratory lung optical density (ELOD) – from (786.05  6.15) to (830.23  4.71) ODU. For patients with COPD stage II the most common radiographic sign was the presence of amplification and deformation pulmonary pattern (95 (89%) of 107 patients); the mean values of ILOD ranged from (646.20  4.94) to (791.38  2.81) ODU, ELOD – from (677.34  9.91) to (813.91  3.29) ODU. Patients with COPD stage III were characterized by a combination of amplification and deformation pulmonary pattern (77 (90%) of 86 patients) with lung emphysema (51 (59%) of 86 patients); the mean values of the inspiratory lung optical density ranged from (765.93  16.4) to (863.37  15.83) ODU, expiratory lung optical density – from (826.80  11.64) to (881.37  4.29) ODU. Thus, we concluded that the method of digital chest fluorography, possessing low dose burden to the patient, can detect the characteristic radiological symptoms and determine the stage of the disease up to the values of the lung optical density in patients with COPD.

scholarly journals Bronchoalveolar pH and inflammatory biomarkers in patients with acute exacerbation of chronic obstructive pulmonary disease

2018 ◽  
Vol 47 (2) ◽  
pp. 791-802 ◽  
Author(s):  
Emilija Lozo Vukovac ◽  
Kornelija Miše ◽  
Ivan Gudelj ◽  
Irena Perić ◽  
Darko Duplančić ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Bacterial Pathogens ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Glucose Levels ◽  
Arterial Blood ◽  
Bronchoalveolar Fluid ◽  
The Mean

Objectives This study aimed to directly measure pH in the lungs, determine lactate dehydrogenase (LDH), C-reactive protein (CRP), and glucose levels in serum and bronchoalveolar aspirate, and identify bacterial pathogens from bronchoalveolar fluid during acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods We performed an observational, analytical case–control study from February 2015 to March 2017. We included 84 patients with AECOPD and 42 with stable chronic obstructive pulmonary disease (COPD). All participants underwent detailed medical anamnesis, a clinical examination, chest radiography, spirometry, an arterial blood gas test, bronchoscopy, bacterial culture, and serum/bronchiolar aspirate laboratory testing. Results The mean pH of bronchoalveolar fluid was significantly higher in patients with AECOPD than in patients with stable COPD. The mean lung pH value, bronchoalveolar and serum LDH levels, and serum CRP levels in patients with isolated bacteria were higher than those in patients without isolated bacteria in the AECOPD patient group. Lung pH values in patients with AECOPD were significantly correlated with bronchoalveolar LDH and glucose levels. Conclusions AECOPD is associated with local cell and tissue injury in the lungs, especially in the presence of bacterial pathogens, which is accompanied by a low systemic inflammatory response.

scholarly journals The Significance of Elevated Brain Natriuretic Peptide Levels in Chronic Obstructive Pulmonary Disease

2005 ◽  
Vol 33 (5) ◽  
pp. 537-544 ◽  
Author(s):  
E Bozkanat ◽  
E Tozkoparan ◽  
O Baysan ◽  
O Deniz ◽  
F Ciftci ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Brain Natriuretic Peptide ◽  
Pulmonary Disease ◽  
Natriuretic Peptide ◽  
Forced Expiratory Volume ◽  
Gas Analysis ◽  
Arterial Oxygen ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Arterial Blood

We investigated the clinical significance of brain natriuretic peptide (BNP), a cardiac hormone, in chronic obstructive pulmonary disease (COPD). Subjects were 38 patients with stable COPD, of whom 20 had cor pulmonale (CP), and 22 were healthy individuals. Plasma BNP levels were measured and pulmonary arterial pressure (PAP) was estimated by echocardiography. Arterial blood gas analysis, forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) were also recorded. BNP levels of patients with COPD were higher than those of controls (48.2 ± 37.5 and 9.3 ± 3.0 pg/ml). Patients with CP had a higher mean BNP level with respect to those without CP (73.9 ± 35.8 and 21.0 ± 10.2 pg/ml, respectively). BNP levels correlated with PAP ( r = 0.68), partial arterial oxygen pressure ( r = −0.70), FEV1 ( r = −0.65) and FVC ( r = −0.52). We have concluded that BNP determination has a role in the diagnosis of CP in patients with COPD.

Effect of Fenspiride on Pulmonary Function in the Rat and Guinea Pig

1995 ◽  
Vol 88 (3) ◽  
pp. 325-330 ◽  
Author(s):  
D. Bee ◽  
E. A. Laude ◽  
C. J. Emery ◽  
P. Howard
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Arterial Oxygen Tension ◽  
Whole Body ◽  
Arterial Oxygen ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Arterial Blood ◽  
Airways Resistance ◽  
Anti Inflammatory

1. Fenspiride is an anti-inflammatory agent that may have a role in reversible obstructive airways disease. Small, but significant, improvements have been seen in airways function and arterial oxygen tension in patients with mild chronic obstructive pulmonary disease. These changes have been attributed to the anti-inflammatory properties of the drug. However, airways function can be improved by other means, e.g. improved ventilation/perfusion ratio or reduced airways resistance. The possibility that fenspiride may have actions other than anti-inflammatory was investigated in two animal species. 2. In the rat, actions on the pulmonary circulation were investigated in the isolated perfused lung, but fenspiride proved to be a poor pulmonary vasodilator, showing only a small reversal of the raised pulmonary artery pressure induced by hypoxia. 3. Ventilation was measured in the anaesthetized rat using whole-body plethysmography. Fenspiride caused no increase in ventilation or changes in arterial blood gases. However, a profound hypotensive action was observed with high doses. 4. The possibility that a decrease in airways resistance (Raw) might occur with fenspiride was investigated in anaesthetized guinea pigs. Capsaicin (30 μmol/l) was used to increase baseline Raw through bronchoconstriction. Fenspiride gave a dose-dependent partial reversal of the raised Raw, and its administration by aerosol proved as efficacious as the intravenous route. In addition, the hypotensive side-effect found with intravenous injection was alleviated by aerosolized fenspiride. 5. An anti-bronchoconstrictor action of fenspiride could be one of the mechanisms involved in improving airways function and Pao2, seen in mild chronic obstructive pulmonary disease.

scholarly journals Outcome of early use of non-invasive positive pressure ventilation in patients with acute exacerbation of chronic obstructive pulmonary disease

2019 ◽  
Vol 35 (6) ◽  
Author(s):  
Nadia Ishfaq ◽  
Naheed Gul ◽  
Neelum Zaka
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Positive Pressure Ventilation ◽  
Positive Pressure ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Non Invasive ◽  
Early Use ◽  
The Mean

Objective: To determine the outcome of early use of non-invasive positive pressure ventilation (NIPPV) in Pakistani patients with acute exacerbation of chronic obstructive pulmonary disease. Methods: This descriptive study was conducted at Shifa International Hospital Islamabad from April 2015 to January 2017. A total of 120 patients with acute exacerbation of chronic obstructive pulmonary disease receiving NIPPV alongside standard therapy were included in the study. The patients were clinically assessed before starting on NIPPV. The parameters of respiratory rate, pH and paCO2 were monitored and NIPPV was given for six hours to evaluate clinical outcomes and analyze the factors predicting failure (requirement of mechanical ventilation and mortality). Frequency and percentages were calculated for qualitative variables while Mean and Standard Deviation for quantitative variables. Chi-square and t-test were used to see differences in pre and post NIPPV arterial blood gases. Results: Patients’ mean age was 58.88±10.09 years. Males were 88 (73.3%) and females were 32 (26.7%). The mean respiratory rate was 24±1.45 per minute before and 17.96±1.35 per minute after NIPPV (p < 0.00001). The mean pH before NIPPV was 7.27±0.04 and afterwards 7.38±0.02 (p < 0.00001). The mean pCO2 was 61.87±9.60 mm of Hg before and 57.46±6.79 mm of Hg after NIPPV (P < 0.0003). Twenty Four (20%) patients required invasive ventilation of which 19 (15.8%) patients could not survive. Conclusions: There was remarkable improvement in the arterial blood gases after NIPPV. However, the high mortality rate and significant number of COPD patients requiring mechanical ventilation necessitates further investigation into our population. doi: https://doi.org/10.12669/pjms.35.6.857 How to cite this:Ishfaq N, Gul N, Zaka N. Outcome of early use of non-invasive positive pressure ventilation in patients with acute exacerbation of chronic obstructive pulmonary disease. Pak J Med Sci. 2019;35(6):1488-1492. doi: https://doi.org/10.12669/pjms.35.6.857 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals The influence of oxygenotherapy on the hypercapnia in patients with chronic obstructive pulmonary disease

2008 ◽  
Vol 65 (7) ◽  
pp. 521-524
Author(s):  
Zorica Lazic ◽  
Ivan Cekerevac ◽  
Ljiljana Novkovic ◽  
Vojislav Cupurdija
Keyword(s):  
Carbon Dioxide ◽  
Chronic Obstructive Pulmonary Disease ◽  
Respiratory Failure ◽  
Pulmonary Disease ◽  
Oxygen Therapy ◽  
Chronic Obstructive ◽  
Average Increase ◽  
Obstructive Pulmonary Disease ◽  
Initial Values ◽  
Arterial Blood

Background/Aim. Oxygen therapy is a necessary therapeutic method in treatment of severe chronic respiratory failure (CRF), especially in phases of acute worsening. Risks which are to be taken into consideration during this therapy are: unpredictable increase of carbon dioxide in blood, carbonarcosis, respiratory acidosis and coma. The aim of this study was to show the influence of oxygen therapy on changes of arterial blood carbon dioxide partial pressure. Methods. The study included 93 patients in 104 admittances to the hospital due to acute exacerbation of CFR. The majority of the patients (89.4%) had chronic obstructive pulmonary disease (COPD), while other causes of respiratory failure were less common. The effect of oxygenation was controlled through measurement of PaO2 and PaCO2 in arterial blood samples. To analyze the influence of oxygen therapy on levels of carbon dioxide, greatest values of change of PaO2 and PaCO2 values from these measurements, including corresponding PaO2 values from the same blood analysis were taken. Results. The obtained results show that oxygen therapy led to the increase of PaO2 but also to the increase of PaCO2. The average increase of PaO2 for the whole group of patients was 2.42 kPa, and the average increase of PaCO2 was 1.69 kPa. There was no correlation between the initial values of PaO2 and PaCO2 and changes of PaCO2 during the oxygen therapy. Also, no correlation between the produced increase in PaO2 and change in PaCO2 during this therapy was found. Conclusion. Controlled oxygen therapy in patients with severe respiratory failure greatly reduces the risk of unwanted increase of PaCO2, but does not exclude it completely. The initial values of PaO2 and PaCO2 are not reliable parameters which could predict the response to oxygen therapy.

scholarly journals The Effect of Exercise on Oxygen Content in Anemic Patients With Chronic Obstructive Pulmonary Disease

2018 ◽  
Vol 12 ◽  
pp. 117954841879648
Author(s):  
Ahmet Sinan Copur ◽  
Hannan Dogar ◽  
Zhang Chao ◽  
Leandra Wallace ◽  
Kevin Henegar ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Oxygen Content ◽  
T Test ◽  
Walking Distance ◽  
Chronic Obstructive ◽  
Continuous Variables ◽  
Obstructive Pulmonary Disease ◽  
Arterial Blood ◽  
Before And After

Background: Anemia is reported in one-third of the patients with chronic obstructive pulmonary disease (COPD). Anemia, by decreasing oxygen content, can be a contributing factor for hypoxemia. We determined to find whether anemia causes more prominent hypoxia by decreasing the total oxygen content after exercise in anemic patients with COPD. Methods: Stable moderate-to-severe COPD patients with and without anemia were recruited. Arterial blood gas analyses were performed on room air before and after a 6-minute walking test (6MWT). Walking distance, oxygen saturation, and heart rate were recorded in each case before and after the 6MWT. Pulmonary function test measurements and other data were obtained from the chart. The mean and standard deviations were calculated for continuous variables. The independent t-test and Kruskal-Wallis test were performed for numerical covariate and univariate analyses. The paired t-test was used for the analyses of data before and after exercise. Results: A total of 24 male patients were included in the study; 12 of which were anemic. The oxygen content was decreased in the anemic group (15.22 ± 1.28 vs 15.07 ± 1.22) after exercise, but it was not significant. In the non-anemic group, no oxygen content decrease was observed after exercise (18.83 ± 1.41 vs 18.9 ± 1.37). Interestingly, the Spo2, but not Sao2, was significantly lower after exercise in anemic patients with COPD (93.46% ± 5.06% vs 88.20% ± 6.35% before and after exercise, respectively). Conclusions: Anemia does not cause more prominent hypoxemia after exercise in patients with COPD. However, the recorded Spo2 levels were significantly lower after exercise in the anemic patients with COPD.

Diagnostic Significance of β-Collagen Degradation Products and Osteocalcin in Chronic Obstructive Pulmonary Disease Complicated with Osteoporosis

2021 ◽  
Vol 20 (2) ◽  
pp. 288-292
Author(s):  
Yafeng Ji ◽  
Hongliang Gao ◽  
Yongli Wang ◽  
Xuesheng Jiang
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Degradation Products ◽  
Collagen Degradation ◽  
Chronic Obstructive ◽  
Characteristic Analysis ◽  
Mineral Density ◽  
Obstructive Pulmonary Disease ◽  
Predictive Values ◽  
Collagen Degradation Products

Chronic obstructive pulmonary disease is a pulmonary dysfunction common to the middle-aged and elderly population. About 20–60% of patients with moderate or severe chronic obstructive pulmonary disease suffer from different degrees of osteoporosis. A strong relationship between β-collagen degradation products and osteocalcin has been shown in several bone diseases, but their roles in chronic obstructive pulmonary disease remain to be investigated. This study was designed to explore such a relationship in patients with chronic obstructive pulmonary disease complicated with osteoporosis. The β-collagen degradation products were the highest in the serum of patients diagnosed with both chronic obstructive pulmonary disease and osteoporosis followed by those with chronic obstructive pulmonary disease only and osteoporosis only. According to the receiver operating characteristic analysis curves, both β-collagen degradation products and osteocalcin had favorable predictive values for patients with chronic obstructive pulmonary disease, osteoporosis or both. In addition, β-collagen degradation products were negatively correlated with forced expiratory volume in 1 s and bone mineral density, while osteocalcin was positively correlated with them. β-collagen degradation products increase, and osteocalcin decreases in patients with both chronic obstructive pulmonary disease and osteoporosis.

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