Showing posts with label COPD. Show all posts
Showing posts with label COPD. Show all posts

Saturday, May 26, 2018

COPD: Cleansing the lungs

COPD (chronic obstructive pulmonary disease) causes difficulty in breathing, exacerbates cough and increases mucus production. The ability to clean the lungs, help to conserve energy and oxygen, and prevent lung infections.


Key points


To cleanse the lungs, you can take the following steps:




  • Cough management. A deep cough clears the lungs of mucus, removing it into the respiratory tract.



  • Postural drainage, by giving the patient a position in which fluid flows under the influence of gravity.



  • Thoracic percussion. Light shocks will weaken the mucus in the lungs.



The effect of mucus on the lungs and overall health?


Usually, the mucus in the body is liquid. It performs a protective function and moistens the lining of organs, such as the lungs, stomach, and intestines. It also helps to remove the bacteria. However, with COPD, mucus is produced more dense, which can lead to its accumulation in the lungs and airways. This makes breathing difficult and puts the patient at risk for infections.


Infections of the respiratory tract and cough cause wheezing and difficulty breathing. Infection can lead to greater production of mucus in the lungs, which becomes more dense. Slime can also change color.



[caption id="attachment_613" align="aligncenter" width="259"]COPD lungs COPD lungs[/caption]

Why is it necessary to control a cough, postural drainage and chest percussion to cleanse the lungs?


You can not restore the health of your lungs. But by controlling the cough, you can drain the mucus of their lungs. This will help:




  • Open the airways and facilitate breathing.



  • Prevent infections.



  • Treat the symptoms and improve well-being.



Cough management


Cough is the body's way of getting rid of mucus. The cough with which you clear the lungs must go deep from the lungs. This weakens the mucus by moving it into the airways. It is best to do this after using an inhaler or other medications. Follow the instructions:




  • Sit on the edge of the chair.



  • Slightly lean forward and relax.



  • Take a slow breath.



  • Cough 2-3 times.



  • Sniff again slowly. Do not make rapid or deep breaths with your mouth. This can block mucus from coming out of the lungs or cause an uncontrolled cough.



  • Relax and repeat all over again.



Postural drainage


Postural drainage occurs by giving the patient a position in which fluid flows under the action of gravity.


Take all positions for 5 minutes and approximately 30 minutes after using the inhaler. Make sure you have an empty stomach. If you started to cough, take a sitting position. Follow the instructions.


Lie down on the bed or the floor. Use pillows in different positions.




  • Cleansing the front of the lungs



Lie on your back. Make sure your breasts are below your hips. Place two pillows under the buttocks.


Follow the instructions: Put one hand on the stomach, the other on the chest, inhale. You should feel a shift of the hand on the abdomen, while the hand on the chest should remain motionless. This is called diaphragmatic breathing.




  • Cleansing of the side parts



Place a pillow under your hip, lying on your side, inhale. After 5-10 minutes, turn over to the other side.




  • Cleansing of the back of the lungs



Lie on your stomach.


Place two or three pillows under your hips. Breathe in your belly.


Thoracic percussion


Light shocks in the chest will weaken the mucus in the lungs.


Follow the instructions:




  • Fold your hand with a handful and hit it lightly on the chest.



  • Consult a physician about safe areas. Avoid jolting in the area of the spine and sternum.



  • You can ask someone to help you.



These three methods may not be effective for everyone, consult a doctor about alternative methods of lung cleansing.


It is very important to remain active and continue to exercise in COPD. Training will help:




  • Strengthen your muscles and develop endurance.



  • Reduce shortness of breath.



Always consult a doctor before starting any sports program.

COPD: Breathing is easier

Chronic obstructive pulmonary disease causes difficulty breathing. It is impossible to restore lung health, but one can prevent complications and improve well-being.


Key points




  • If you have COPD, you will notice that you are doing quick, shallow breathing.



  • It is important to avoid shortness of breath.



  • Teaching proper breathing will help get rid of shortness of breath and take deep breaths.



  • Practicing proper breathing is necessary regularly.



What is breathing training?


Quick, superficial breaths complicate the flow of air into the lungs.


You can try three basic ways to facilitate breathing:




  • Inhaling with closed lips helps to breathe more air.



  • The inhalation of the diaphragm helps the lungs open up to absorb more air. The diaphragm is a large muscle between the lungs and the stomach.



  • The inhalation in the forward slope facilitates an easier movement of the diaphragm.




[caption id="attachment_611" align="aligncenter" width="282"]COPD Breathing COPD Breathing[/caption]

Why should you use these methods of breathing?


One of the main symptoms of COPD is shortness of breath, which is aggravated by physical exertion. Breathing takes a lot of energy, patients often lose weight and become weaker. Small superficial breaths make it difficult for air to enter the lungs. The study of new ways to control breathing in these cases will help improve well-being and get rid of the discomfort.


How to use these breathing techniques?


Use these methods when necessary and practice as often as possible.


Breathing with closed lips


Breathing with closed lips (meaning not tightly closed) helps to get more air into the lungs. This allows you to perform physical activities.




  • Breathe in with your nose and mouth, almost closing your lips.



  • Breathe for about 4 seconds, then make a slow exhalation for 6 to 8 seconds.



Diaphragm breathing


Breathing with a diaphragm expands the lungs and receives more air. The diaphragm is a large muscle between the lungs and the stomach.




  • Lie on your back.



  • Put one hand on your stomach, the other on your chest, inhale. You should feel the movement of the hand on your stomach, while the hand on your chest should remain motionless. Practice this method of breathing for 20 minutes, 2 - 3 times a day.



Breathing when tilted forward


Breathing in this way will reduce shortness of breath during exercise and rest. You can apply this method in a sitting or standing position.


The doctor's consultation


If you have any questions about breathing techniques, consult your doctor.

COPD: Causes

COPD is most often caused by smoking. Most patients with COPD are smokers with experience:




  • Approximately 10 to 15 smokers out of 100 have COPD.



  • Some studies show that half of smokers with experience older than 45 years suffer from COPD.



  • COPD is basically a combination of two diseases: chronic bronchitis and emphysema. Both diseases are caused by smoking.



Chronical bronchitis


Almost all patients with chronic bronchitis smoke. Over time, tobacco smoke and other irritants can lead to inflammation of airways (bronchioles). As a result, airways produce more mucus than normal. Inflammation and excessive cough cause excessive production of mucus and narrow the airways.



[caption id="attachment_607" align="aligncenter" width="310"]Causes of COPD Causes of COPD[/caption]

Emphysema


With emphysema, tobacco smoke and other irritants can damage elastic fibers in the lungs. These elastic tissues are necessary for normal lung function. When elastic fibers are damaged, tiny air sacs (alveoli) are damaged at the end of the bronchioles. The alveoli are the place where the blood exchanges carbon dioxide (a byproduct of metabolism) for oxygen. With lesions, the walls of the alveoli become large and transmit less oxygen to the blood. Destroyed alveoli can not be replaced.


Other reasons


Other possible causes of COPD include:




  • Prolonged exposure to irritants (industrial dust, chemical vapors) on the lungs.



  • Low birth weight and repeated infections of the lungs.



  • Inherited factors (genes), including antitrypsin alpha 1 deficiency, are a rare disease in which the body can not produce a protein (antitrypsin alpha 1) that protects the lungs from damage. In smokers with this disease, the symptoms of emphysema appear by 30-40 years.


COPD: Symptoms

With COPD:




  • There is a constant cough.



  • Often coughing up mucus.



  • Appears shortness of breath.



Exacerbation of COPD


Many patients with COPD are prone to attacks and exacerbations of the disease, which are quite dangerous and can lead to hospitalization.


Symptoms include:




  • Expectoration of more mucus.



  • Change in color or density of mucus.



  • Appearance of shortness of breath.




[caption id="attachment_604" align="aligncenter" width="368"]COPD Symptoms COPD Symptoms[/caption]

These seizures are most often caused by infections - such as bronchitis and pneumonia, as well as contaminated air. The doctor will help to draw up a plan of action for sudden exacerbations of the disease. Such training will help control symptoms and avoid panic attacks.


Stages of COPD


The stages of COPD are often determined according to the symptoms. The leading analysis is the volume of forced expiration in 1 second, which is measured with a spirometer.



Easy COPD (stage 1)





  • Frequent, but not permanent cough, which raises mucus from the lungs



  • Function of light FEV1 (volume of forced expiration in 1 second) - 80%




Moderate COPD (2nd stage)





  • Chronic cough with a lot of mucus



  • Dyspnea, especially with exercise



  • Function of easy FEV1 50% - 79%




Severe COPD (stage 3)





  • Chronic cough with a lot of mucus



  • Dyspnea



  • Weight loss



  • Exacerbations of COPD



  • FEV1 lung function 30% - 49%




Very severe COPD (stage 4)





  • Chronic cough with a lot of mucus



  • Dyspnea



  • Weight loss



  • Blue skin, especially the skin of the lips, fingers and toes



  • The accumulation of fluid in the legs (edema)



  • Sensation of stomach overflow



  • Disorientation due to an overabundance of carbon dioxide and lack of oxygen in the blood



  • Life-threatening exacerbations of COPD



  • FEV1 lung function 30% - 49%



Diseases with similar symptoms


Diseases that cause such symptoms include:




  • Heart failure.



  • Disease of the coronary artery.



  • Asthma.



  • Cystic fibrosis.



  • Pulmonary fibrosis.



  • Expansion of the bronchi.


COPD: When to Call a Doctor

Call the emergency room if you experience:




  • Blocking of breathing.



  • Difficulty breathing.



  • Severe chest pain.



Call a doctor immediately if you have previously been diagnosed with COPD and you:




  • Expecting blood.



  • Have developed shortness of breath or wheezing, which is rapidly aggravated.



  • You experience chest pain.



  • Cough more often than usual and notice a change in the color of the expectorated mucus.



  • Have noticed swelling of the legs or abdomen.



  • Developed a high temperature.



  • Developed the symptoms of influenza.



If your symptoms (cough, mucus, and / or dyspnea) suddenly deteriorate, it can be an exacerbation of COPD.



[caption id="attachment_603" align="aligncenter" width="256"]COPD Doctor COPD Doctor[/caption]

Call a doctor if:




  • Your medicine does not help you.



  • Symptoms gradually worsen.



You have a cold and:




  • Your fever lasts longer than 2 - 3 days.



  • Dyspnea became much worse.



  • Cough aggravated or lasts longer than 7 to 10 days.



  • You have not been diagnosed with COPD, but you have symptoms. Smoking increases the likelihood of COPD.



  • You're coughing up blood.



Consult your doctor


If you are diagnosed with COPD, ask your doctor for advice on:







  • Annual vaccination against influenza.



  • Vaccination against pneumonia.



  • Physical training and rehabilitation programs for the lungs.



  • Any renewal or substitution of medication or therapy.



Who to contact


To medical professionals who can diagnose and treat COPD, include:




  • Family doctors.



  • Therapists.



  • Nurses of the highest qualification.



  • Assistant physician.




You can also be referred to a pulmonologist if:





  • Your diagnosis of COPD is uncertain.



  • You have unusual symptoms.



  • You are under 50 and do not smoke.



  • You often go to the hospital because of sudden exacerbations of breathlessness.



  • You need long-term oxygen therapy or corticosteroid treatment.



  • You are thinking about surgery, for the purpose of a lung transplant or a reduction in lung volume.


COPD: Analyzes and Examinations

For the diagnosis of COPD, the doctor will perform the following:




  • Will study anamnesis and will conduct a physical examination.



  • Check lung function, using spirometry.



  • Will make a chest x-ray. This will help to rule out other diseases with similar symptoms.



Surveys that are prescribed if necessary




  • Arterial blood test for gases and acidity.



  • Oxymetry measures the oxygen saturation of the blood.



  • An electrocardiogram or an echocardiogram



  • Carbon dioxide transfer factor.




[caption id="attachment_601" align="aligncenter" width="246"]COPD Examinations COPD Examinations[/caption]

Surveys that are prescribed in rare cases




  • Analysis of measurement of antitrypsin alpha level 1.



  • CT scan.



Regular checks


Since COPD is a disease that is aggravated, the doctor will prescribe regular examinations and tests:




  • Spirometry.



  • A blood test for gases and acidity.



  • X-ray and cardiogram.



It is important to inform the attending physician about any changes in symptoms and exacerbations, he can change the treatment plan and prescribe alternative drugs.


Early diagnosis


The earlier COPD is diagnosed, the sooner the patient can take steps to slow the progression of the disease and maintain a quality of life. The tests will help the doctor diagnose COPD before any symptoms appear.


Consult your doctor about testing if you:




  • You smoke.



  • Burn asthma for a long period of time.



  • Have a genetic predisposition to emphysema.



  • Work in a zone of high concentration of chemicals and dust.


COPD: An Overview of Treatment

Although COPD can not be cured, it can be controlled. 


Treatment objectives:




  • Slow down the disease, avoiding tobacco smoke and polluted air.



  • Limit symptoms such as shortness of breath.



  • Increase the level of activity.



  • Improve your health.



  • Prevent and treat sudden exacerbations of the disease.



Most people with COPD continue to live in their usual rhythm of life.


Initial treatment


COPD treatment in the initial stages facilitates breathing and slows down the disease. You need:



[caption id="attachment_599" align="aligncenter" width="275"]COPD Treatment COPD Treatment[/caption]



  • Quit smoking. It's very important and it's never too late. No matter how long you live with COPD, quitting smoking will slow the illness and improve the quality of life. Today, there are many ways to quit smoking.



  • Active life position. If you remain active, you will be able to control shortness of breath and are less likely to feel depressed or isolated.



  • Take care of your health. Influenza, pneumonia, and other diseases that damage the lungs can exacerbate COPD. Do your best to avoid them:



    • Wash your hands often.



    • Avoid contact with sick people.



    • Consult with your doctor about the annual vaccination of influenza and pneumonia.





  • Adhere to a balanced diet. Muscle weakness and weight loss are common in severe COPD, making it difficult for the body to fight the disease.



  • Avoid trigger factors. Avoid factors that can cause a sudden exacerbation of the disease, including polluted air, cold dry air and hot, humid air.



  • Learn how to breathe. Learn the methods of breathing to increase the flow of air into the lungs. Learn ways to cleanse the lungs to conserve energy and oxygen.



  • Rest more often. Give yourself time to rest in the breaks between household chores and other activities.



Oxygen treatment


Oxygen treatment is used mainly to prevent right-sided heart failure.


Medications




  • Bronchodilator funds. These drugs open the bronchial intubation tubes, which facilitates breathing and reduces symptoms.



  • Anti-inflammatory drugs, such as corticosteroids, can be in the form of pills or be used with an inhaler. If you use an inhaler, be sure to read the instructions to it.



  • Expectorants. These drugs will facilitate the expectoration of mucus.



  • Treatment of muscle weakness and weight loss. Many patients with COPD have a problem with weight that can be treated, paying attention to regular and balanced meals.



  • Rehabilitation program for the lungs. The doctor can offer this program for training breathing and proper selection of physical exertion.



Surgery as a form of COPD treatment is not very common, but there are several types of COPD:




  • Reducing the volume of the lung involves removing part of one or both of the lungs.



  • Transplantation of the lung.



  • Bullectomy removes bullae from the lungs.



Heart failure, which damages the right side of the heart and is called the pulmonary heart, is common in people with COPD. Treatment can consist of oxygen and a diuretic.


About what it is worth remembering


COPD treatment is applicable on an ongoing basis, but it is worth remembering that COPD is a disease that can be fatal. You and your doctor should discuss all treatment options, as well as an action plan in case of exacerbations.

COPD: Prevention

Do not smoke: the best way to protect yourself from COPD is to quit smoking. By refusing to smoke, you slow down the damage to your lungs. Today, there are many ways to quit smoking. Quitting smoking is especially important if you have a low level of antitrypsin alpha 1 protein.


Avoid contaminated air: other respiratory irritants (such as contaminated air, chemical vapor, and dust) can also exacerbate COPD symptoms.



[caption id="attachment_597" align="aligncenter" width="345"]COPD Prevention COPD Prevention[/caption]



  • Prevention of other diseases




Influenza vaccination: if you have COPD, you need an annual flu vaccination. Patients with COPD are more prone to complications, such as pneumonia, so vaccination will reduce this risk. In addition, vaccination will reduce the risk of sudden exacerbations of COPD.


Vaccination of pneumonia: People with COPD often get pneumonia, so pneumococcal vaccine will reduce this risk.

COPD: Continuous treatment

Over time, COPD is aggravated. Dyspnea worsens along with other symptoms of COPD.


If the diagnosis is made in the early stages, you may be able to avoid serious lung damage.


It is very important to stop smoking




  • If you continue to smoke, the symptoms of COPD will worsen more quickly, and you will be more at risk of other serious illnesses.



  • Damage to the lung can not be cured and restored, but you can take control of the symptoms of the disease if you quit smoking.



Complications



[caption id="attachment_595" align="aligncenter" width="299"]COPD treatment COPD treatment[/caption]

The health problems caused by COPD include:




  • Sudden exacerbation of COPD, manifested in the form of sudden attacks of cough, wheezing, and / or the amount or color of mucus that you refract.



  • Increased lung infections, such as pneumonia.



  • Increased risk of osteoporosis, especially if you are taking corticosteroids.



  • Depression or anxiety. COPD can limit the ability to work and can reduce your independence, sexual activity, social activity, and self-esteem. This often causes depression, and difficulty breathing can cause a feeling of excitement.



  • Problems with weight. If chronic bronchitis is the basis of COPD, you will probably lose weight. With emphysema, you can gain weight and muscle mass.



  • Heart failure that damages the right side of the heart.



  • Pneumothorax. COPD can damage the structure of the lung, which will lead to the ingress of air into the chest cavity.



  • Problems with sleep due to lack of oxygen in the lungs.



COPD treatment is improved, which improves the quality of life of patients, but COPD can also be exacerbated and lead to fatal consequences.


It is important to talk with your doctor about these problems:




  • How do you see "your death"? Do you want to fight for life to the end? Do you want a peaceful, peaceful death?



  • If you experience sudden, life-threatening breathing problems, do you want artificial ventilation?



  • What other alternative treatments are you ready for?



  • Do you want to sign a document on transferring to another person the rights to make important medical decisions in case of loss of legal capacity?


COPD: Living with a disease


The main points in the treatment of COPD:




  • To give up smoking.



  • Work on shortness of breath.



  • A balanced diet and an active lifestyle.



  • Awareness.



  • Support for loved ones.




[caption id="attachment_593" align="aligncenter" width="259"]COPD COPD[/caption]

It is very important to stop smoking


If you continue to smoke, the symptoms of COPD will worsen more quickly, and you will be more at risk of other serious illnesses. Damage to the lung cannot be cured and restored, but you can take control of the symptoms of the disease if you quit smoking.



 

COPD: Medications

Drugs used to treat COPD:




  • Reduce shortness of breath.



  • Help control coughing and wheezing.



  • Prevent sudden exacerbations of COPD.



Most people confirm that the drugs facilitate breathing. Some medicines should be used with inhalers or nebulizers.


COPD Medications


Choice of drugs


Bronchodilator funds. These drugs open the bronchial intubation tubes, which facilitates breathing and reduces symptoms.


Broncholytic fast-acting agents relieve symptoms. These include:




  • Anticholinergics.



  • The agonists Beta 2 (albuterol, levalbuterol).



  • A combination of these two.



Bronchodilators with long-term action help prevent respiratory problems. They are intended for patients with chronic symptoms. These include:




  • Anticholinergics.



  • The beta 2. agonists ( salmeterol, formoterol , and arformoterol ).



  • Corticosteroids (prednisone) can be used as pills to treat sudden exacerbations of COPD or as an inhaler. They are also used for asthma.



Other drugs include:




  • Expectorants



  • Methylxanthines , which are used in severe COPD cases. They can have serious side effects.



About what it is worth remembering


Using a bronchodilator for the first time, you may not notice its effect. This does not always mean that the drug does not help. Try the same drug take a little later.


Dosing inhalers and nebulizers work equally well.


Most patients who use the inhaler do not know how to use it properly. Consult your doctor regarding instructions for use.

COPD: symptoms, treatment

Chronic obstructive pulmonary disease (COPD) is a group of chronic respiratory diseases of adults, adolescents and children: emphysema, chronic obstructive bronchitis, bronchiolitis obliterans, severe bronchial asthma, bronchiectasis and cystic fibrosis. The main feature that combines the above-mentioned diseases in the COPD group is a progressive irreversible bronchial obstruction with increasing phenomena of chronic respiratory failure.



  • Treatment

  • Bronchodilators

  • Corticosteroids

  • Pronounced impaired sputum emptying

  • Infusion therapy

  • Prevention of venous thrombosis and embolism

  • Non-invasive and invasive ventilation

  • Pulmonary heart


 






















For instrumental objectification of the severity of the process, measure the volume of forced expiration in 1 s (FEV1) - NICE Grading of Severity of Airflow Obstruction: severity of obstruction



Force of forced expiration,%



Moderate



50-80



Average



30-49



Heavy



<30



COPD develops mainly in people aged 40 and over, progressing at a slow pace. Severe and extremely severe course of the disease mainly falls on the age of 55 to 65 years. Usually, patients with such a diagnosis are under the supervision of doctors for many years, which gives a higher chance of delivering a correct and accurate diagnosis. When a person's condition becomes extremely serious, he falls into a coma, often there is a hospitalization in the ICU. But it is worth knowing that doctors can not radically help these patients.


COPD symptoms, treatmentDoctors should also remember: not all patients can be helped. And not all patients with severe COPD decompensation should be admitted to the intensive care unit. If the patient is still brought to the ICU, physicians should try to avoid invasive mechanical ventilation if the person has COPD decompensation. In most cases, the patient is brought to the department in the stage of decompensation, with severe respiratory failure and manifestations of the pulmonary heart.


Drowsiness of a person can talk about concomitant hypercapnia. Blood saturation is below 90-92%. In this phase of the disease, therapy with bronchodilators and corticosteroids often does not give the desired, expected effect. The treating doctor has to transfer the patient to controlled breathing. The condition of a person in such cases, as a rule, becomes better. But further to the doctors stands a much more complicated, often insoluble, task - how to disconnect the patient from the apparatus of artificial ventilation?


Monitoring


All patients should be given a radiograph of the lungs. Conduct blood pressure control, heart rate, ECG, blood gases, peak expiratory flow rate, blood electrolytes, hematocrit, glucose, creatinine, blood saturation.


Treatment


Treatment should be carried out in this order. First, oxygen therapy is started with nasal catheters at a rate of 1-2 liters per minute. A high rate of oxygenation, especially in patients with severe hypercapnia (drowsiness is a clinical manifestation of hypercapnia), can cause the development of apnea. Further, the oxygen delivery rate of the physicians is adjusted to provide an acceptable level of oxygenation (saturation of 88-92%). The patient takes a forced sitting or semi-sitting position. You can not put the patient lying in bed.


Provide venous access using peripheral venous catheters. If a person is in a coma, there are signs of severe respiratory failure, you must immediately intubate the trachea and begin ventilating.


Bronchodilators


Most people with COPD in a stage of decompensation respond moderately to bronchodilator therapy. If a person took beta-2-agonists or anticholinergics before entering the ICU, the best solution of the doctor will be to continue inhalation of that beta-2 agonist or anticholinergic that previously had a positive effect, this information should be found in the patient or relatives.


It is advisable to use a nebulizer powered by a compressor, not oxygen. Given the low sensitivity of patients to bronchodilators, in all severe cases, beta-2 agonists and anticholinergics are combined.


Preparations for nebulizer therapy in COPD :



  • Salbutamol 2.5 mg (Berotek 1 mg = 20 drops) at intervals of 30 minutes to 4-6 hours;

  • Ipratropium bromide (also marketed under the name Atrovent) 0.5 mg (40 drops) at intervals of 2 hours to 4-6 hours;

  • Berodual 2.0 ml (40 drops), spacing 2-6 hours. Berodual is a combined bronchospasmolytic drug that contains 2 bronchodilators: fenoterol (beta-2 agonist) and ipratropium



In the absence of a nebulizer, short-acting metered-dose aerosol beta-2 agonists, terbutaline sulphate (analogue: Bricanyl®), salbutamol (analogue: Ventolin), Berodual (combination drug), fenoterol hydrobromide (Berotek), and / or anticholinergic drugs - ipratropium (atrovent), oxytropium bromide (analog: Oxyvent). Efficacy will be greater if the metered-dose inhaler is equipped with a spacer.


At the beginning of therapy, a person immediately inhales from 3 to 6 doses. If there is no effect, inhalation should be repeated after 20 minutes. In the future, inhalations are carried out in accordance with the instructions to the drug. When using these drugs, contraindications should be considered: severe hypertension, rhythm disturbances, etc. And monitor the concentration of potassium in the plasma, if the patient receives beta-2-agonists - possibly a rapid development of hypokalemia.


Introduction of euphyllinum


It is used in case of inefficiency of beta-2-agonists and anticholinergics or inability to use them. Do not administer eufillin if the patient was administered it regularly before admission. The loading dose of the drug is 2-4 mg per 1 kg of the patient's body for 20 minutes IV (10 ml 2.4% euphyllin).


Supportive therapy: 0.5 mg / kg per hour. With congestive heart failure, severe liver disease, pneumonia, this dosage should be used: 0.25 mg / kg / h. When using aminophylline, the indicated dosages are reduced by twenty percent. The introduction of euphyllin is recommended to continue until a marked improvement in the condition of a person - an average of 24 hours, sometimes even a longer period.


Corticosteroids


Inhaled corticosteroids are attributed only to patients with a proven clinical or spirometric response or with FEV1 less than 50% of that due or with repeated exacerbations. Long-term use of systemic corticosteroids can not. The effect of these drugs develops mainly in 2-4 hours from the beginning of admission (an average of 2-6 hours), the effectiveness is low.


In case of severe exacerbation, if a person is unable to take medications alone, prednisolone ( dexamethasone , hydrocortisone in appropriate dosages) at a dose of 0.5-1 mg / kg after 6 hours intravenously for 2 hours. Then, the daily dose of medics is reduced to 40-60 mg per day. In more mild cases, it is necessary to prescribe prednisone tableted for 5-10 mg 4 times a day. The duration of taking systemic corticosteroids is 10-14 days.


N-acetylcysteine


N-acetylcysteine, which is prescribed at a dose of 1200 mg per day during exacerbation, contributes to a faster improvement in the human condition.


Pronounced impaired sputum emptying


In the presence of viscous, difficult-to-cough phlegm, it is necessary to carry out measures that contribute to its dilution and enhance drainage. Initially, procedures can worsen a patient's condition by increasing the amount of sputum and increasing bronchospasm.


Physicians should explain to the patient the necessity of these procedures and to warn that at first his condition can become worse. Depending on the available drugs and the clinical situation, doctors prescribe:



  • N-acetylcysteine (Fluimucil) nebulizer - nebula 3 ml 10% solution, 1-2 times a day;

  • Inhalation of a solution of furosemide ( Lasix ) 0.5-1 mg per 1 kg of the patient's body. In a day to spend 2-3 sessions. This disease reduces the viscosity of phlegm, almost always well tolerated by patients;

  • With a large amount of purulent viscous sputum in humans, it can be attributed to inhalation of 3-7.5% sodium chloride. This method is not well tolerated by everyone. Inhalation should be carried out using 5-10 ml of r-ra, after 3-4 hours. Before each inhalation of sodium chloride, inhalation is made with beta-2 agonists;

  • Inhalation is recommended to alternate with sessions for 10-15 minutes VCIVL (intensifies sputum drainage);

  • With a strong, painful cough, you can prescribe a patient inhaled lidocaine 1% - 5.0.



Infusion therapy


If you can take liquid and food, you usually enter the volume taken by the patient. If there are disturbances of consciousness, such a patient is given probe nutrition. In rare cases, patients need intravenous infusion therapy. The efficiency criteria are as follows: restoration of diuresis more than 60ml / hour, reduction of dry skin, thirst reduction, hematocrit within 0.35-0.40.


Hypervolaemia and large volumes of fluid are contraindicated. With CVP more than 12 cm of water. Art. Infusion therapy should be discontinued. Increased blood pressure decreases with the improvement of the patient's condition, usually, there is no need for medication. If the SBP is less than 90 mm Hg. st., it is necessary to apply the introduction of vasopressors (dopamine, epinephrine).


Prevention of venous thrombosis and embolism


Thromboembolism of the pulmonary artery (PE) is a common cause of decompensation in COPD. At autopsy PE patients are fixed in every 4 patients from those who were admitted to the hospital with a diagnosis of "exacerbation of COPD". For this reason, prophylaxis of deep vein thrombosis and PE is performed by physicians to virtually all patients with exacerbation of COPD, if no contraindications are found.


Low molecular weight heparins used in usual preventive doses cause fewer side effects and are more convenient to use. Therapy lasts on average from 7 to 14 days (until the patient's condition is improved and activated).


Antibiotics


Very often decompensation of COPD is associated with infectious processes - sinusitis, pneumonia, bronchitis and so on. Therefore, almost all patients need antibiotics. In chronic obstructive pulmonary disease, the most common pathogens provoking inflammation are: pneumococcus, hemophilic rod, various viral-bacterial associations. Accordingly, respiratory fluoroquinolones ( hemifloxacin , moxifloxacin), protected aminopenicillins (piperacillin / tazobactam, amoxicillin / clavulanate), modern macrolides are the drugs of choice.


If the patient was in the hospital for a long time before entering the intensive care unit, there is a high probability of joining the hospital gram-negative flora, mainly of Pseudomonas aeruginosa. This medicine should be considered when prescribing antibiotics (cefoperazone, ceftazidime).


Non-invasive and invasive ventilation


Noninvasive ventilation (NIVL) is considered to be the most important innovation in the conservative therapy of patients with COPD decompensation in recent years. The method allows to reduce nosocomial mortality and hospitalization of patients, reduces the need for invasive artificial ventilation (IVL). NIVL facilitates the transfer of a person to independent breathing after an invasive mechanical ventilation. But modern breathing apparatus and appropriate monitoring are needed.


Indications for non-invasive ventilation


NIVL is assigned if at least one of the following conditions exists:



  • Respiratory acidosis (pH equal to or less than 7.35 and / or PaCO2 is equal to or greater than 6.0 kPa, or 45 mm Hg);

  • Severe shortness of breath with clinical signs of fatigue of the respiratory muscles and / or increased load on the respiratory muscles (paradoxical movement of the abdomen, participation of auxiliary respiratory muscles or entraining intercostal spaces).



For these purposes, pressure-sensitive modes are available, of which there are only three: Pressure support; BiPAP; Proportional Assist. The use of a complete helmet mask is the most comfortable option for the patient.


Experienced doctors know that it is necessary to perform a certain selection of patients. A person should be in a clear consciousness, have stable indicators of hemodynamics, have a desire to cooperate with a doctor. If there is no improvement in the patient's condition (saturation, gases and blood pH, xymptoms) within 1-2 hours after the onset of NIVL, one should consider the need for mechanical ventilation.


Indications for invasive pulmonary ventilation


The presence of any of the following signs may serve as a basis for carrying out artificial ventilation:



  • Inability to evacuate the bronchial secretion, increasing fatigue and exhaustion of a person;

  • Stopping breathing or heart activity;

  • Intolerance or ineffectiveness of NIVL;

  • Appearance of coma harbingers;

  • Bradycardia or arterial hypotension;

  • Increasing hypercapnia more than 60 mm mercury column against the background of hypoxemia (PaO2 55-65 mm Hg, Sp02 less than 90%);

  • Breathing pauses with loss of consciousness or sensation of suffocation.



Technology of ventilation


At the initial stage, mechanical ventilation is used similar approaches for those with exacerbation of bronchial asthma. Ventilation with pressure control (PCV) can be a method of choice in patients with severe hypoxemia and hypercapnia. It is recommended to try to keep the patient's respiratory activity, for which there are auxiliary ventilation modes (BIPAP, SIMV + PSV, etc.). And doctors need to try as soon as possible to transfer a person to independent breathing. The shorter the duration of invasive ventilation, the lower the mortality in these patients.


Pulmonary heart


Diagnosis of the pulmonary heart is established by such signs:



  • enlargement of the shadow of the heart on the chest X-ray,

  • swelling of the jugular veins,

  • hypertrophy of the right ventricle,

  • ECG signs,

  • presence of peripheral edema.



Echocardiography can confirm the dysfunction of the right ventricle, since swelling is not always associated with right ventricular failure and pulmonary hypertension. To reduce fluid retention, intravenous furosemide is administered intravenously at a dose of 1 mg / kg.


Drugs that are better not to be prescribed for exacerbation of COPD


The appointment of cardiac glycosides and ACE inhibitors in the pulmonary heart is not recommended. The regulation of respiration in severe exacerbation of COPD is disturbed, and many drugs can aggravate these disorders. It is necessary to try without extreme necessity not to prescribe sedatives (especially from the group of benzodiazepines), antidepressants, narcotic analgesics, as during artificial ventilation of the lungs, and even more so without ventilator.

Friday, May 4, 2018

COPD: Avoid Trigger Factors

Key Points to COPD: Avoid Trigger Factors


You can reduce the risk of sudden exacerbations of the disease, avoiding trigger factors.


Key points




  • Study and avoid the main trigger factors for COPD.



  • Avoiding sudden exacerbations of the disease, you will feel better and can reduce the impact of COPD on your life.



  • Pay attention to the warning signs, regarding the sudden exacerbation of the disease. You may need to see a doctor.



The main trigger factors in COPD


The trigger factor is a circumstance that aggravates the symptoms and aggravates the disease. These include:




  • Such diseases as cold, flu, or pneumonia.



  • Contaminated air, smoke or smog.



  • Tobacco smoke.



  • Cool dry air, hot, humid air or high altitude.



  • Cleaning agents and other chemical components.



  • Pollen, dust and dust mite.



  • Wool, leather, or saliva of pets.



  • Gases and pairs of home heaters.



  • Refusal to take medication.




Not all patients have identical triggers. What can cause a sudden exacerbation of the disease in one person may not be a problem for another at all.



Why is it important to avoid trigger factors?


Sudden exacerbations of COPD can limit your activity. Sometimes, it can even lead to hospitalization. Avoiding sudden exacerbations, you can stay active and reduce the impact of COPD on your life.


That is why, it is important to pay attention to the symptoms. The exacerbation of the disease is due to:




  • The appearance of stridor and shortness of breath.



  • An intensified cough or discolouration of the coughing mucus.



  • The appearance of a fever, problems with sleep and a sense of fatigue.



How to avoid trigger factors?



To protect yourself from the impact of trigger factors:





  • Quit smoking. This is the main point from which treatment begins.



  • Use an air conditioner or an air filter in your home.



  • Prepare food near an open door or window, or turn on the fan.



  • If the streets are dusty or polluted air, stay at home and close the windows.




Protect your health





  • Go through the annual vaccination.



  • Consult with your doctor about the need for pneumococcal vaccination.



  • Wash your hands to avoid infections.



  • Adhere to a balanced diet, a healthy lifestyle and enough rest.



  • Do not forget to take medicines while traveling.



After you have read this information, you will be able to determine, and therefore avoid the triggers of COPD.


Consult your doctor


If you have any questions, contact your doctor.

COPD: avoid losing weight

Key points on COPD: avoid losing weight


Some people with the severe chronic obstructive pulmonary disease - especially those who have emphysema - can have a reduced body weight and inadequately eat.


Patients with COPD often lose weight, and when losing weight a person loses muscle mass, including the muscles involved in the process of breathing. This makes breathing difficult.


Approximately every 4 patients with COPD weigh less than normal.



To avoid weight loss, eat more foods that contain fat and protein. Because large amounts of fat can be hazardous to health, consult your doctor or dietitian.



Although the causes of weight loss in COPD are not fully understood, experts believe that this is due to a combination of factors, which include:




  • The need for more energy.



  • Consuming more energy with physical activity.



  • Dyspnea.



  • The use of corticosteroids, which accelerate the breakdown of muscle tissue in the body.



  • Side effects of some drugs include a decrease in appetite.



  • COPD can reduce the level of oxygen in the blood.




[caption id="attachment_578" align="aligncenter" width="356"]COPD: avoid losing weight COPD: avoid losing weight[/caption]

Why weight loss is dangerous in COPD?


Weight loss is dangerous in COPD, due to loss of muscle tissue, which leads to a feeling of weakness and difficulty breathing. Weakness in turn leads to a greater risk of developing infections, such as pneumonia. Approximately every 4 patients with COPD weigh less than the norm and are at risk of death.


How to avoid weight loss in COPD?


If you start to lose weight, then you should eat more protein and get more calories. This means that you need to eat more foods that contain fat and protein. Since such food is a health hazard, consult a therapist or a nutritionist before starting a new diet.


High-calorie, nutritious snacks


Foods that contain many calories include:




  • Ice cream.



  • Pudding.



  • Cheese.



  • Bars of muesli.



  • Custard.



  • Corn chips with cheese.



  • Eggs.



  • Crackers with peanut butter.



  • Buns with peanut butter or cream cheese.



  • Pop corn with parmesan cheese.



  • High-calorie food additives.



Add calories to snacks


To add calories to snacks, try:




  • Add egg or egg yolk to meat, pasta, cheese and similar products.



  • Add the powdered milk to the soup, scrambled eggs, pudding, potatoes and yogurt.



  • Add cheese to sandwiches, crackers, casseroles, soups, toast and pasta.



  • Add an extra tablespoon of vegetable or olive oil, mayonnaise, butter, margarine or sour cream to sandwiches, bread, casseroles, soups, pasta, potatoes, rice and vegetables.



  • Add crushed nuts in pudding, sauce, mashed potatoes, casserole, salad and yogurt.



Add protein to your diet


Dairy and meat products contain a large number of proteins. Try to use more of these foods or:




  • Add the milk powder to the scrambled eggs, soup and meat.



  • Add cheese or butter to appetizers.



  • Choose desserts made with eggs - biscuit, custard and rice pudding.



  • Use food supplements that are high in protein.



If you have COPD and you are worried about weight loss, consult a therapist or a nutritionist. It will help you to create a balanced, high-calorie and high-protein diet. If you consume more calories, but continue to lose weight, consult a doctor.

Thursday, November 23, 2017

COPD (Chronic Obstructive Pulmonary Disease): Overview

This article explains about COPD - Chronic Obstructive Pulmonary Disease, causes of COPD, how COPD diagnosed, how to treat COPD and much more.


COPD (Chronic Obstructive Pulmonary Disease): Overview


COPD is a lung disease that causes difficulty breathing. This is caused by lung damage for many years, usually by smoking.


COPD is often a combination of two diseases:




  • Chronic bronchitis - inflammation of the respiratory tract and increased production of mucus. This can narrow or block the airways, making breathing difficult.



  • Emphysema - a disease of the respiratory tract, characterized by a pathological expansion of the air spaces of the terminal bronchioles, which is accompanied by destructive changes in the alveolar walls of COPD, is aggravated over time. Health can not be restored easily, but damage can be prevented.



Causes of COPD


COPD is almost always caused by smoking. Prolonged inhalation of tobacco smoke irritates the respiratory tract and destroys the elastic fibers in the lungs. Risk factors also include the inhalation of chemicals, dust and contaminated air for a long period of time.


Usually, lung damage does not occur at an early age, COPD symptoms begin to appear in people older than 60 years.


More susceptible COPD patients who suffered serious infections of the lungs in childhood. People who fall ill with emphysema at 30-40 years may have abnormalities called antitrypsin deficiency alpha 1. But this happens very rarely.


Symptoms of COPD


The main symptoms are:




  • Prolonged (chronic) cough.



  • Mucus when coughing.



  • Shortness of breath, which is aggravated by physical exertion.



Because COPD is aggravated, difficulty breathing can occur even when performing simple actions - eating or dressing. Patients often lose weight and become weaker. From time to time, the symptoms can become aggravated and aggravated.


How is COPD diagnosed?


For diagnosis of COPD, a physician:




  • Perform a survey and listen to the lungs.



  • Ask questions about past illnesses and smoking.



  • Spends spirometry.



  • Assign chest X-ray and other tests to exclude other problems that could cause symptoms.



COPD


How to treat COPD


The only way to slow the development of COPD is to quit smoking. This is the main point on which the course of the disease depends. Regardless of how long you smoke, giving up this habit will stop lung damage.


If it's difficult for you to stop smoking, consult a doctor. He will give the best advice and, if necessary, prescribe certain drugs.


The doctor will prescribe a treatment that will ease the symptoms and improve your health.




  • Medications can help ease breathing. If you are prescribed an inhaler, use it according to the instructions.



  • The program of rehabilitation of the lungs will help you in the future to avoid exacerbations.



  • Periodically you will use oxygen.



Patients with COPD are more susceptible to lung infections, so doctors strongly recommend that they undergo an annual vaccination against influenza and pneumonia.


At home, patients should:




  • Avoid exposure to irritants such as smoke, dust, or dry air.



  • Use air conditioner or air filter.



  • To have a rest during the day.



  • Perform regular physical activity.



  • It is good and balanced to eat. If you lose weight, consult a therapist or a nutritionist.



What you need to remember




  • Sudden exacerbations of the disease: As COPD aggravates, sudden exacerbations of the disease can occur. In such cases it is necessary to consult a doctor or, in severe cases, an emergency room.



  • Depression and anxiety: if you have a note of depression, see a doctor. Recommended medicine and support groups will help you cope with emotional disorders.



COPD - Health Tools


Health tools will help you make the right decision and the necessary measures to improve your health.




  • Powder inhaler



  • Dosing inhaler



  • Avoid losing weight



  • Avoid Trigger Factors



  • Cleansing the lungs



  • Compliance with a healthy diet



  • Training for easy breathing



  • Physical exercise to improve well-being



  • Oxygen therapy


4.5 out of 5 stars Reviewer:adminFebruary 05, 2021