Search results for "DYSPNEA"

High Flow Nasal Therapy Use in Patients with Acute Exacerbation of COPD and Bronchiectasis: A Feasibility Study

2020

The efficacy and feasibility of high flow nasal therapy (HFNT) use in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and bronchiectasis is unknown. We performed a single-center, single-arm prospective observational study in patients with AECOPD, documented bronchiectasis, pH >= 7.35, respiratory rate (RR) >= 26 breaths/minute despite receiving maximal medical treatment and oxygen via face mask up to 10 L/m. Patients received HFNT (Airvo 2, Fisher & Paykel) at a gas flow of 50 L/min and FIO2 adjusted to maintain SpO(2) >= 92%. Dyspnea, rated by Borg scale, RR, arterial blood gases and mucus production (ranging from 1 to 3) were collected befor…

Satisfaction with chronic obstructive pulmonary disease treatment: results from a multicenter, observational study

2019

Background: Understanding the level of patients’ satisfaction with treatment and its determinants have the potential to impact therapeutic management and clinical outcome in chronic conditions such as chronic obstructive pulmonary disease (COPD). Methods: A national, multicenter, longitudinal, observational study of COPD from 20 Italian pulmonary centers to explore patients’ satisfaction to treatment [assessed by the Treatment Satisfaction Questionnaire, 9 items (TSQM-9)] and association with clinical parameters [including dyspnea score, COPD Assessment Test (CAT) score, exacerbation rate], adherence to treatment [Morisky Medication-Taking Adherence Scale (MMAS-4)], illness perception [eval…

Spontaneous pneumomediastinum and subcutaneous emphysema as a complication of asthma in children: case report and literature review

2016

Background:Spontaneous pneumomediastinum (SPM) is an uncommon disorder. It is rarely reported in paediatric patients and may be accompanied by subcutaneous emphysema. It is usually benign and self-limiting, with only supportive therapy being needed, but severe cases may require invasive measures. Asthma exacerbations have classically been described as a cause of SPM. However, detailed descriptions in asthmatic children are scarce. We aimed at improving the current understanding of the features of SPM and subcutaneous emphysema, and outcomes, by means of a case report and a systematic review.Methods:For the systematic review a literature search was performed in PubMed to identify reported ca…

Should we use gait speed in COPD, FEV 1 in frailty and dyspnoea in both?

2016

Frailty is a progressive physiological decline in multiple organ systems marked by loss of function, loss of physiological reserve and increased vulnerability to disease [1]. Biological (inflammation and loss of hormones), clinical ( e.g. sarcopenia and osteoporosis) and social factors are involved in frailty onset, evolution and prognosis [2, 3]. Links between frailty, dyspnoea and chronic respiratory diseases represent a novel and practical approach

Patient-Ventilator Asynchronies: Clinical Implications and Practical Solutions

2020

Mechanical ventilation is a supportive treatment commonly applied in critically ill patients. Whenever the patient is spontaneously breathing, the pressure applied to the respiratory system depends on the sum of the pressure generated by the respiratory muscles and the pressure generated by the ventilator. Patient-ventilator interaction is of utmost importance in spontaneously breathing patients, and thus the ventilator should be able to adapt to patient's changes in ventilatory demand and respiratory mechanics. Nevertheless, a lack of coordination between patient and ventilator due to a mismatch between neural and ventilator timing throughout the respiratory cycle may make weaning difficul…

A Case of Severe Dyspnea and an Unusual Bronchoscopy: The Chilaiditi Syndrome

2006

Frailty Assessment in a Stable COPD Cohort: Is There a COPD-Frail Phenotype?

2021

The frailty syndrome increases the morbidity/mortality in older adults, and several studies have shown a higher prevalence of this syndrome in patients with Chronic Obstructive Pulmonary Disease (COPD). The aim of this study was to identify the characteristics of frail patients with COPD to define a new phenotype called "COPD-frail." We conducted a cross-sectional study in a cohort of patients with stable COPD, classified as either frail, pre-frail, or non-frail. Sociodemographic, clinical, and biochemical variables were compared between the three groups of patients. The study included 127 patients, of which 31 were frail, 64 were pre-frail, and 32 non-frail. All subjects had FEV1/FVC below…

[Recommendations for end-of-life care in patients with chronic obstructive pulmonary disease].

2009

Over the last 20 years, advances in the treatment of patients with chronic obstructive pulmonary disease (COPD) have improved survival even among patients in the most advanced stages of the disease, such as those requiring domiciliary oxygen therapy.1,2 This improvement—in principle a positive development—has given rise to considerable clinical problems associated with the establishment of a therapeutic ceiling and the difficulty of determining prognosis in some of these patients. In this situation, the clinician should consider introducing palliative care, that is, care aimed at improving symptom control, communication, physical activity, and emotional support, in order to achieve the best…

Multidisciplinary intervention in the management of breathlessness in people with non-malignant chronic diseases in advanced situation

2018

Resumen El presente trabajo muestra una revisión crítica de un artículo en que se presentan los resultados de un ensayo clínico realizado en un hospital de Reino Unido para estudiar los resultados de una intervención con enfoque paliativo utilizada en el manejo de la disnea en pacientes con enfermedades crónicas en fases avanzadas. Tras el resumen del artículo, destacando los principales resultados obtenidos, se presenta la revisión crítica del artículo, en la que se ha intentado analizar tanto el diseño como la metodología utilizada en el ensayo clínico, como las implicaciones para la práctica de enfermería y especialmente en el ámbito de los cuidados paliativos. Abstract This work shows a…

Airway obstruction in relation to symptoms in chronic respiratory disease—a nationally representative population study

2000

Abstract We examined the severity of airway obstruction and the occurrence of respiratory symptoms in a large, nationally representative population sample and in a subgroup of subjects with chronic bronchitis and/or emphysema to obtain information for developing national prevention and treatment strategies for these diseases. The study population comprised of 7217 randomly selected subjects (aged 30 years and older) who participated in a comprehensive health examination survey. The ‘cases' were subjects diagnosed as having chronic bronchitis and/or emphysema. The survey methods comprised of questionnaires, interviews, physical measurements, including spirometry, and clinical examinations. I…