scholarly journals Effect of Lianhuaqingwen Capsules on Airway Inflammation in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

2014 ◽  
Vol 2014 ◽  
pp. 1-11 ◽  
Author(s):  
Liang Dong ◽  
Jing-wen Xia ◽  
Yi Gong ◽  
Zhen Chen ◽  
Hai-hua Yang ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
High Risk ◽  
Airway Inflammation ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Western Medicine ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Chronic Inflammatory Response ◽  
Exacerbation Of Copd

Chronic obstructive pulmonary disease (COPD) is characterized by a chronic inflammatory response that is worsened by acute exacerbations. Lianhuaqingwen (LHQW) has anti-inflammatory and immune regulatory functions and may inhibit the airway inflammation that occurs during an acute exacerbation of COPD. In this study, 100 participants were recruited and randomly assigned, 1 : 1, to the LHQW and the conventional groups, which were treated, respectively, with LHQW capsules and conventional Western medicine or only conventional Western medicine. The scores of the CAT scale and levels of inflammatory cytokines in blood and sputum were measured during treatment. In addition, subjects were subdivided into high-risk and low-risk subgroups. The CAT scores in the LHQW group and high-risk subgroup were clearly improved from the 5th day, but the other groups improved only after treatment was completed. Expression levels of IL-8, TNF-α, IL-17, and IL-23 in the sputum and of IL-8 and IL-17 in the blood were significantly decreased after treatment, and similar results were found in subgroups. These data suggested that LHQW capsules can accelerate the improvement of AECOPD patients, especially for the high-risk subgroup, and the mechanism of action may be related to the decreased release of inflammatory mediators.

Serum Electrolyte in Acute Exacerbation of Chronic Obstructive Pulmonary Disease

2020 ◽  
Vol 13 (1) ◽  
pp. 9-13
Author(s):  
Chandra Prasad Acharya ◽  
Kalpana Paudel
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Chronic Obstructive ◽  
Serum Electrolyte ◽  
Obstructive Pulmonary Disease ◽  
Acute Exacerbation Of Copd ◽  
Electrolyte Disorder ◽  
The Mean ◽  
Exacerbation Of Copd

Introduction: Chronic Obstructive Pulmonary Disease (COPD) is one of the leading causes of mortality and morbidity worldwide. Though COPD is mainly a chronic disease, many patients experience exacerbations that are related to worst survival outcome, especially with abnormal serum electrolyte level. The objective of this study was to evaluate serum electrolyte levels among the patients with acute exacerbation of COPD. Methods: Structured questionnaire and patients’ charts were used to collect data. Data was analyzed using Statistical Package for the Social Sciences (SPSS) software version 16.0 and descriptive statistics were used to generate the research findings. Results: The mean age of the patients with Acute exacerbation of COPD was 69.57± 9.765 years. Among 100 patients, (83%) belonged to the age group of 60 years and above, (54%) were male, (74%) were married, (52%) were illiterate and (41%) were engaged in agriculture, (41%) consumed alcohol and (67%) were smokers. Dyspnoea (90%) was the most common symptom. The mean level of sodium and potassium were 133.8±4.830 mEq/L, 3.6±0.533 mmol/L, respectively. Fifty seven percent patients had electrolyte disorder. More than half (51%) had hyponatremia and (40%) had hypokalemia. The average value of pH, PaCO2 and PaO2 are 7.34 ± 0.727, 46.64 ± 9.787 mm Hg and 69.38 ± 9.255 mm Hg respectively. Among them, (18%) were in respiratory failure. Conclusion: This study concluded that hyponatremia and hypokalemia are prevalent electrolyte disorder with AE of COPD patients. Therefore, we recommend routine monitoring of the serum electrolytes for better outcomes of patients.

scholarly journals Risk factors for early readmission after acute exacerbation of chronic obstructive pulmonary disease

2020 ◽  
Vol 14 ◽  
pp. 175346662096168
Author(s):  
Yong Suk Jo ◽  
Chin Kook Rhee ◽  
Kyung Joo Kim ◽  
Kwang Ha Yoo ◽  
Yong-Bum Park
Keyword(s):  
Risk Factors ◽  
Chronic Obstructive Pulmonary Disease ◽  
High Risk ◽  
Hospital Stay ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Chronic Obstructive ◽  
Systemic Steroid ◽  
Care Programme ◽  
Obstructive Pulmonary Disease

Background and aims: Patients discharged after treatment for acute exacerbation of chronic obstructive pulmonary disease (COPD) are at high risk for readmission. We aimed to identify the prevalence and risk factors for readmission. Methods: We included 16,105 patients who had claimed their medical expenses from 1 May 2014 to 1 May 2016 after discharge from any medical facility in Korea, following treatment for acute exacerbation of COPD. We analysed the potential risk factors for readmission within 30 days of discharge. Results: Readmission rate was 26.4% (3989 patients among 15,101 patients) and over 50% of readmissions occurred within 10 days of discharge. Approximately 57% of readmissions occurred due to respiratory causes. Major causes of readmission were COPD (27%), pneumonia (14.2%), and lung cancer (7.1%), in that order. Patients who were readmitted were male, had more comorbidities and were less frequently admitted to tertiary hospitals than those who were not readmitted. Risk factors for readmission within 30 days of discharge were male sex, medical aid coverage, longer hospital stay, longer duration of systemic steroid use during hospital stay, high comorbid condition index, and discharge to skilled nursing facility. Conclusion: Readmission occurred in approximately one-quarter of patients, and was associated with patient-related and clinical factors. Using these results, we can identify high-risk patients for readmission and precautions are needed to be taken before deciding on a discharge plan. Further research is needed to develop accurate tools for predicting the risk of readmission before discharge, and development and evaluation of an effective care programme for COPD patients are necessary. The reviews of this paper are available via the supplemental material section.

scholarly journals A Prediction Model for Intermediate- and High-risk Pulmonary Hypertension During the Acute Exacerbation of Chronic Obstructive Pulmonary Disease

2021 ◽  
Author(s):  
Xilian Feng ◽  
Jiahua Liang ◽  
Jiamin Chen ◽  
Weiyan Chen ◽  
Hui Li ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Hypertension ◽  
High Risk ◽  
Prediction Model ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Clinical Efficacy ◽  
Chronic Obstructive ◽  
Discriminative Ability ◽  
Obstructive Pulmonary Disease

Abstract Background: Pulmonary hypertension (PH) is a serious complication of COPD and is associated with poor prognosis. There are currently no established predictive models for PH during the acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Objective: To establish a prediction model for intermediate- and high-risk PH in AECOPD patients.Methods: This study collected data from 203 AECOPD patients and divided the patients into a model group and an external validation group. The influence of each parameter on PH was analysed through univariate and multivariate analyses, and these data were used to build a prediction model. Finally, the discriminative ability, calibration ability and clinical efficacy of the model were tested.Result: Age, RDW-CV and RDW-SD were related to PH, so these variables were used to establish a prediction model. In addition, the discriminative ability, calibration ability and clinical efficacy of the model were affirmed.Conclusion: This study established a clinical prediction model for AECOPD patients with PH, and the prediction model has certain clinical value for assisting in the screening of intermediate- and high-risk patients with PH.

scholarly journals Possibilities to prevent acute exacerbation of chronic obstructive pulmonary disease using inhalational therapy. A Report of Expert Panel of Russian Respiratory Society

2018 ◽  
Vol 28 (3) ◽  
pp. 368-380 ◽  
Author(s):  
S. N. Avdeev ◽  
A. S. Belevskiy ◽  
Z. R. Aisanov ◽  
V. V. Arkhipov ◽  
I. V. Leshchenko ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Clinically Significant ◽  
Long Acting ◽  
Exacerbation Of Copd ◽  
Inhalational Therapy

An impact of acute exacerbation of COPD (AECOPD) on the course and the prognosis of chronic obstructive pulmonary disease depends on severity of the exacerbation. Moderate and severe exacerbations are considered as clinically significant events. Clinical studies investigating a role of inhalational therapy for the risk of AECOPD differed significantly in important parameters and the patients involved were not fully described in the real clinical practice. Tiotropium alone did not demonstrate any benefit over other inhalational therapies, such as inhaled corticosteroid/long-acting β2-agonist (ICS/LABA) combinations and long-acting muscarinic antagonist (LAMA)/LABA combinations, for risk reduction of moderate to severe exacerbations. A benefit of tiotropium/olodaterol combination over tiotropium for the reduction of risk of clinically significant exacerbations was first shown in DYNAGITO study; patients’ groups in this study did not differ in a rate and a spectrum of adverse events including cardiovascular events. An efficient bronchodilating therapy should be administered to all patients with COPD as it could improve dyspnea and prevent exacerbations. Further escalation of treatment in patients with frequent exacerbations of COPD should be personalized according to clinical course and causes of AECOPD. 

scholarly journals Host-Pathogen Interaction during Pneumococcal Infection in Patients with Chronic Obstructive Pulmonary Disease

2004 ◽  
Vol 72 (2) ◽  
pp. 818-823 ◽  
Author(s):  
Debby Bogaert ◽  
Paul van der Valk ◽  
Reshmi Ramdin ◽  
Marcel Sluijter ◽  
Evelyn Monninkhof ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Pneumococcal Infection ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Antibody Titers ◽  
Pneumococcal Colonization ◽  
Exacerbation Of Copd

ABSTRACT Acute exacerbation is a frequent complication of chronic obstructive pulmonary disease (COPD). Recent studies suggested a role for bacteria such as Streptococcus pneumoniae in the development of acute exacerbation. For this study, we investigated the following in COPD patients: (i) the epidemiology of pneumococcal colonization and infection, (ii) the effect of pneumococcal colonization on the development of exacerbation, and (iii) the immunological response against S. pneumoniae. We cultured sputa of 269 COPD patients during a stable state and during exacerbation of COPD and characterized 115 pneumococcal isolates by use of serotyping. Moreover, we studied serum immunoglobulin G (IgG) antibody titers, antibody avidities, and functional antibody titers against the seven conjugate vaccine serotypes in these patients. Colonization with only pneumococci (monocultures) increased the risk of exacerbation, with a hazard ratio of 2.93 (95% confidence interval, 1.41 to 6.07). The most prevalent pneumococcal serotypes found were serotypes 19F, 3, 14, 9L/N/V, 23A/B, and 11. We calculated the theoretical coverage for the 7- and 11-valent pneumococcal vaccines to be 60 and 73%, respectively. All patients had detectable IgG levels against the seven conjugate vaccine serotypes. These antibody titers were significantly lower than those in vaccinated healthy adults. Finally, on average, a 2.5-fold rise in serotype-specific and functional antibodies in S. pneumoniae-positive sputum cultures was observed during exacerbation. Our data indicate that pneumococcal colonization in COPD patients is frequently caused by vaccine serotype strains. Moreover, pneumococcal colonization is a risk factor for exacerbation of COPD. Finally, our findings demonstrate that COPD patients are able to mount a significant immune response to pneumococcal infection. COPD patients may therefore benefit from pneumococcal vaccination.

Pilot Study to Assess the Credibility of Acupuncture in Acute Exacerbations of Chronic Obstructive Pulmonary Disease

2009 ◽  
Vol 27 (1) ◽  
pp. 13-15 ◽  
Author(s):  
Claudia A Whale ◽  
Sarah J A MacLaran ◽  
Christopher I Whale ◽  
Mandy Barnett
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pilot Study ◽  
Visual Analogue Scale ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Analogue Scale ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Acute Exacerbation Of Copd ◽  
Exacerbation Of Copd

Background Exacerbation of chronic obstructive pulmonary disease (COPD) is a common reason for hospital admission, and adjunctive non-pharmacological treatments would be welcomed. A pilot study was undertaken to assess the feasibility of conducting a study of acupuncture during an acute exacerbation of COPD. We also examined the credibility of a sham device in this setting and assessed the effect of acupuncture on breathlessness and anxiety. Methods A prospective, randomised, patient- and assessor-blinded, sham controlled study was conducted on three consecutive days in a district general hospital. Credibility of both acupuncture and the Park sham device were assessed using the Borkovec and Nau questionnaire. Dyspnoea was measured on the modified Borg score and a 10 cm visual analogue scale, while anxiety was measured on a 10 cm visual analogue scale. Results 11 patients were recruited and nine completed the study. There were no adverse events with either intervention. Acupuncture was well tolerated and credibility scores were similar before and after real and sham acupuncture. Symptoms improved after both treatments, with no significant difference between groups. Conclusion In this pilot study acupuncture was well tolerated by subjects experiencing an acute exacerbation of COPD. Acupuncture treatment and the Park sham device were both credible. Although recruitment was slow, a further trial with a larger sample size is feasible and recommended.

scholarly journals ANTIBIOTIC THERAPY IN ACUTE EXACERBATION OF COPD:AN OPTIMAL WAY TO SUCCESS

2021 ◽  
Vol 29 (2) ◽  
pp. 35-40
Author(s):  
L. V. Yudina
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Antibiotic Therapy ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Chronic Obstructive ◽  
Family Practitioner ◽  
Copd Exacerbation ◽  
Obstructive Pulmonary Disease ◽  
Acute Exacerbation Of Copd ◽  
Exacerbation Of Copd

Currently, chronic obstructive pulmonary disease (COPD) is the third leading cause of death globally. Acute exacerbation of the disease is associated with fast clinical deterioration, increased respiratory tract inflammation and lung function disorders. Acute exacerbation of COPD dramatically worsens patient�s prognosis and serves as an important indicator of therapy effectiveness. Family practitioner should recognize this condition and correctly chose proper antibiotic. Diagnosis of COPD exacerbation is based on clinical manifestations of the disease. Depending on presence of primary or secondary symptoms COPD exacerbations are divided into several types. Antibiotic therapy appears to be more beneficial in patients with type 2 or 3 exacerbation. Sputum purulence is considered an obligatory symptom. As a rule, in complicated course of acute exacerbation of COPD protected aminopenicillins or 3rd generation cephalosporins are the firsline antibiotics. In most cases of COPD exacerbation antibiotics are prescribed orally. If first-line antibacterial therapy fails, the respiratory fluoroquinolones (levofloxacin of moxifloxacin) are prescribed. The author, using her own experience with levofloxacin, gives an example of proper choice of antibiotic if such a situation. Successful experience of management of acute exacerbation of COPD may be useful for general practitioners, physicians, pulmonologists. Key words: chronic obstructive pulmonary disease, exacerbation, antibiotic therapy, levofloxacin.

scholarly journals Effectiveness of Xin Jia Xuan Bai Cheng Qi Decoction in treating acute exacerbation of chronic obstructive pulmonary disease: study protocol for a multicentre, randomised, controlled trial

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e030249 ◽  
Author(s):  
Jin Jin ◽  
Hongchun Zhang ◽  
Demin Li ◽  
Yue Jing ◽  
Zengtao Sun ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Western Medicine ◽  
Intestinal Flora ◽  
Controlled Study ◽  
Chronic Obstructive ◽  
High Morbidity ◽  
Obstructive Pulmonary Disease

IntroductionAcute exacerbation of chronic obstructive pulmonary disease (AECOPD) brings a serious impact on patients’ quality of life, and has extremely high morbidity and mortality worldwide. Although there are many therapies being developed to alleviate symptoms and reduce mortality, a few studies have supported which treatment method is the best. Traditional Chinese medicine (TCM) has shown good potential in the prevention and treatment of AECOPD, especially in terms of supplementation and reduction of dosage and adverse effect of Western medicine. The purpose of this study is to compare the effectiveness of combination of TCM and Western medicine with conventional therapy alone for AECOPD, and to ensure whether the combined therapy may reduce the use of systemic glucocorticoid in AECOPD without influencing efficacy.Methods and analysisA multicentre, randomised, double-blind, placebo-controlled study was conducted to enrol a total of 360 eligible patients who will be randomised into integrated Chinese and Western medicine group A, B and Western standard Medicine group C. After 5 days of intervention and 1 month of follow-up, the efficacy and safety of Xin Jia Xuan Bai Cheng Qi Decoction in patients with AECOPD will be observed. The results of evaluation indicators include: clinical symptoms, biochemical indicators such as blood gas analysis, inflammatory markers, hospitalisation time, TCM syndrome evaluation, biological indicators such as airway, intestinal flora sequencing.Ethics and disseminationThis trail has been approved by the Ethics Committee of China-Japan Friendship Hospital. The results will be disseminated in international peer-reviewed journals and be presented in academic conferences. The results will also be disseminated to patients by telephone, inquiring on patient’s poststudy health status during the follow-up.Trial registration numberChiCTR1800016915

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