An Introduction of the Vaporized Therapy with Tea Herb Drink for Relieving Agitation due to Pulmonary Encephalopathy

What methods would you choose apart from increasing sedatives foragitation in an advanced patient with hypercapnic encephalopathy dueto AECOPD? This is a 94-year-old female who suffered from COPD forover 30 years, occurred with an accelerated episode of cough, productivesputum and a dropping down to 86% in SatO₂ due to a cold weather. Adiagnosis of pulmonary encephalopathy (PE) was made on the basis of thesubsequent agitation and delirium, and the sedatives, such as quatiepineand haloperidol, had to be given for her mental excitation respectively, butshe still pulled out indwelling needle herself and refused to any infusiontherapy. As an alternative, a vaporized therapy integrated with tea herbdrinking had to be applied to relieving her agitation, being designedas the vaporization of the inhaled oxygenation by means of high-flowoxygenation device (HFOD), with an ampoule of ambroxol mixed into theinhaler and simultaneous drinking of TCM tea herb for reducing sputum,helping dissolve the mucoid bolts inside her terminal bronchioles whenbeing infected. We thought that a better efficacy would be achieved forhypercapnic encephalopathy due to AECOPD if we concentrate on a goodventilation of small airway through the vaporized therapy.

The Clinical Implications of Carbon Dioxide Increased Level in Arterial Blood Related to Severe Exacerbations of Chronic Obstructive Pulmonary Disease

In the evolution of patients with chronic obstructive pulmonary disease (COPD), exacerbations occur, especially, in severe stages, determining aggravated respiratory failure and decreased survival. In order to evaluate the implications of COPD exacerbations in patients with second type of chronic respiratory failure and hypercapnic encephalopathy, a prospective observational study was done among 195 COPD in patients of Targu Mures Clinical County Hospital, Romania. Inclusion criteria consisted in severe exacerbations of COPD, complicated by hypercapnia, defined by an increased level of arterial blood gas carbon dioxide (PaCO2) �45 mmHg, suggestive for the second type of respiratory failure. The increased values of PaCO2 ranged between 45 and 112 mmHg among 95 patients. The prevalence of hypercapnia in COPD patients, admitted in hospital for severe exacerbations, was high (n=91/195; 46.66%). The majority of COPD patients (93.4%) were initially hospitalized in the intensive care unit (ICU) department because of hypercapnic encephalopathy. The mortality rate was higher among patients with endotracheal tube insertion than in patients treated by noninvasive mechanical ventilation. High levels of hypercapnia, conscience disorders and respiratory acidosis may be considered factors of severity in COPD exacerbation.