An update on pulmonary rehabilitation techniques for patients with chronic obstructive pulmonary disease.

An update on pulmonary rehabilitation techniques for patients with chronic obstructive pulmonary disease. Expert Rev Respir Med. 2020 Jan 14;:1-13 Authors: Wouters EF, Posthuma R, Koopman M, Liu WY, Sillen MJ, Hajian B, Sastry M, Spruit M, Franssen FM Abstract Introduction: Pulmonary rehabilitation (PR) is one of the core components in the management of patients with chronic obstructive pulmonary disease (COPD). In order to achieve the maximal level of independence, autonomy, and functioning of the patient, targeted therapies and interventions based on the identification of physical, emotional and social traits need to be provided by a dedicated, interdisciplinary PR team.Areas covered: The review discusses cardiopulmonary exercise testing in the selection of different modes of training modalities. Neuromuscular electrical stimulation as well as gait assessment and training are discussed as well as add-on therapies as oxygen, noninvasive ventilator support or endoscopic lung volume reduction in selected patients. The potentials of pulsed inhaled nitric oxide in patients with underlying pulmonary hypertension is explored as well as nutritional support. The impact of sleep quality on outcomes of PR is reviewed.Expert opinion: Individualized, comprehensive intervention based on thorough assessment of physical, emotional, and social traits in COPD patients forms a continuous challenge for health-care professionals and PR organizations in order to dynamically ...
Source: Expert Review of Respiratory Medicine - Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

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Authors: Jany B, Bals R, Dreher M, Held M, Jany L, Rembert Koczulla A, Pfeifer M, Randerath W, Watz H, Wilkens H, Steinkamp G Abstract When caring for patients with respiratory diseases, always think of the heart! This is especially important for COPD patients, but also for a variety of other disorders of the respiratory system. At the workshop "Luftschlösser", held once more at Wiesbaden, Germany in February 2019 the many and important interactions of the lungs and the heart as well as the therapeutic implications were discussed. Based on pathophysiology, the psycho-social consequences of dyspnea, t...
Source: Pneumologie - Category: Respiratory Medicine Tags: Pneumologie Source Type: research
Authors: McNicholas WT Abstract Chronic obstructive pulmonary disease (COPD) and obstructive sleep apnoea (OSA) syndrome are both highly prevalent, affecting at least 10% of the general adult population, and each has been independently associated with an increased risk of cardiovascular disease. The presence of both disorders together, commonly referred to as the overlap syndrome, is also highly prevalent, although various clinical and pathophysiological factors associated with COPD may increase or decrease the likelihood of OSA. Lung hyperinflation reduces the likelihood of obstructive apnoea, whereas right heart ...
Source: Journal of Thoracic Disease - Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research
Patent foramen ovale (PFO), an embryonic remnant of the fetal circulation, is present in 20–25% of adults. Although recent observational studies and clinical trials have established the link between PFO-mediated right-to-left shunting with cryptogenic stroke and migraine with aura, the role of a PFO in exacerbating hypoxemic medical conditions (ie, sleep apnea, chronic obstructive pulmonary disease, pulmonary hypertension, platypnea–orthodeoxia, pulmonary arteriovenous malformation, high-altitude pulmonary edema, and exercise desaturation) remains less understood. PFO-mediated hypoxemia occurs when deoxygenated...
Source: Cardiology in Review - Category: Cardiology Tags: Review Articles Source Type: research
Purpose: To identify the clinical significance of episodic nocturnal hypercapnia (eNH), mainly observed during rapid-eye-movement sleep, and the effectiveness of eNH-targeted non-invasive positive pressure ventilation (NPPV) against stable advanced chronic obstructive pulmonary disease (COPD) with eNH.Patients and methods: We enrolled patients with stable, severe, or very severe COPD with PaO2 ≥ 55 mmHg and daytime PaCO2
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Noninvasive Ventilatory Support Source Type: research
Background: Obstructive Sleep Apnoea (OSA) is a common nocturnal respiratory disorder and its role as a risk factor for the development of Pulmonary Hypertension (PH) is well known. It was already demonstrated that systolic pulmonary artery pressure (PAPs) in obese patients with OSA is higher than in obese patients without OSA (Carratù P. et al, Sleep Breath 2016; 20: 613-619).Aims: to evaluate correlations between nocturnal cardiorespiratory indices, as Apnoea-Hypopnea Index (AHI), Oxygen Desaturation Index (ODI) and Total Sleep Time with oxyhemoglobin saturation below 90% (TST90), and PAPs in obese patients affect...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Sleep and control of breathing Source Type: research
Conclusion: Sildenafil was well tolerated in patients with severe group 3 PH, with improved WHO FC, BNP and quality of life, and a good safety signal. Larger studies are warranted.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Pulmonary hypertension Source Type: research
Publication date: December 2017Source: Chinese Medical Sciences Journal, Volume 32, Issue 4Author(s): Wen Wu, Yan Li, Dunquan XuAbstractHypoxic pulmonary hypertension (HPH) is a common complication in patients with chronic obstructive pulmonary disease (COPD), sleep-disordered breathing, or dwellers in high altitude. The exact mechanisms underlying the development of HPH still remain unclear. Reactive oxygen species (ROS), hypoxia inducible factors (HIF), and potassium channels (KV) are believed as the main factors during the development of HPH. We propose that the “ROS/Kv/HIF axis” may play an important initia...
Source: Chinese Medical Sciences Journal - Category: General Medicine Source Type: research
AbstractPurpose of ReviewThe purpose of this article is to provide a brief review of the preoperative pulmonary evaluation of patients undergoing non-thoracic surgery, focusing on risk factor identification, assessment of specific high-risk populations, and strategies to minimize postoperative pulmonary complications (PPCs).Recent FindingsAlong with traditional risk factors, recent risk stratification indices have been developed and validated to help quantify risk of PPCs. Careful history and physical examination are key elements in the pulmonary evaluation of all pre-surgical patients. Patients with chronic obstructive pu...
Source: Current Anesthesiology Reports - Category: Anesthesiology Source Type: research
Conclusions: The body composition with subjects with HF and COPD showed a high deterioration that can lead to a worse condition.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Clinical Problems Asthma Source Type: research
OSA causes chronic hypoxia that adversely affects the clinical manifestations of COPD and may impair cardiac function.The aim is to study cardiohemodynamics in patients with COPD and OSA.A total of 46 pts, 32 men, 14 women, average age of 63,85 (8,34) years, with COPD gr. B and C were examined. Standard values of systolic and diastolic heart function, mean pressure in the pulmonary artery (PAPmean) and the right ventricle (RV) size were measured by EchoCG. OSA was diagnosed by Somnocheck-Micro method. The severity of OSA was assessed by apnea/hypopnea index (AHI).OSA was diagnosed in 67 (44.14%) pts, which were divided int...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Sleep and Control of Breathing Source Type: research
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