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Nonantibiotic Pharmacological Treatment of Severe Chronic Obstructive Pulmonary Disease Exacerbations
Semin Respir Crit Care Med DOI: 10.1055/s-0040-1714379Severe, acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are a rapid deterioration of the respiratory symptoms of patients with COPD, requiring hospital admission and escalation of pharmacological and nonpharmacological care including the more severe cases of respiratory failure and admission to an intensive care unit (ICU). These events severely impact patients' quality of life and prognosis. This review will describe the nonantibiotic, pharmacological treatment options available for critically ill patients with AECOPD. The aim of treatment is to a...
Source: Seminars in Respiratory and Critical Care Medicine - July 28, 2020 Category: Respiratory Medicine Authors: Vasques, Francesco Camporota, Luigi Barrett, Nicholas A. Tags: Review Article Source Type: research

Chronic Obstructive Pulmonary Disease and Lung Transplantation
Semin Respir Crit Care Med DOI: 10.1055/s-0040-1714250Lung transplantation (LTx) has been a viable option for patients with end-stage chronic obstructive pulmonary disease (COPD), with more than 20,000 procedures performed worldwide. Survival after LTx lags behind most other forms of solid-organ transplantation, with median survival for COPD recipients being a sobering 6.0 years. Given the limited supply of suitable donor organs, not all patients with end-stage COPD are candidates for LTx. We discuss appropriate criteria for accepting patients for LTx, as well as contraindications and exclusionary criteria. In the first ye...
Source: Seminars in Respiratory and Critical Care Medicine - July 28, 2020 Category: Respiratory Medicine Authors: Greer, Mark Welte, Tobias Tags: Review Article Source Type: research

Pneumonic versus Nonpneumonic Exacerbations of Chronic Obstructive Pulmonary Disease
Semin Respir Crit Care Med DOI: 10.1055/s-0040-1702196Patients with chronic obstructive pulmonary disease (COPD) often suffer acute exacerbations (AECOPD) and community-acquired pneumonia (CAP), named nonpneumonic and pneumonic exacerbations of COPD, respectively. Abnormal host defense mechanisms may play a role in the specificity of the systemic inflammatory response. Given the association of this aspect to some biomarkers at admission (e.g., C-reactive protein), it can be used to help to discriminate AECOPD and CAP, especially in cases with doubtful infiltrates and advanced lung impairment. Fever, sputum purulence, chill...
Source: Seminars in Respiratory and Critical Care Medicine - July 28, 2020 Category: Respiratory Medicine Authors: Crisafulli, Ernesto Manco, Alessandra Ferrer, Miquel Huerta, Arturo Micheletto, Claudio Girelli, Domenico Clini, Enrico Torres, Antoni Tags: Review Article Source Type: research

Physical Therapy and Rehabilitation in Chronic Obstructive Pulmonary Disease Patients Admitted to the Intensive Care Unit
This article discusses the key considerations for respiratory management of patients requiring invasive mechanical ventilation, providing an evidence-based summary of commonly used interventions. It will also explore the evidence to support the introduction of early and structured programs of rehabilitation to support recovery in both the short and the long term, as well as active mobilization, which includes strategies to minimize or prevent physical loss through early retraining of both peripheral and respiratory muscles. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJourn...
Source: Seminars in Respiratory and Critical Care Medicine - July 27, 2020 Category: Respiratory Medicine Authors: Mart í, Joan Daniel McWilliams, David Gimeno-Santos, Elena Tags: Review Article Source Type: research

Noninvasive Ventilation and High-Flow Nasal Therapy Administration in Chronic Obstructive Pulmonary Disease Exacerbations
Semin Respir Crit Care Med DOI: 10.1055/s-0040-1712101Noninvasive ventilation (NIV) is considered to be the standard of care for the management of acute hypercapnic respiratory failure in patients with chronic obstructive pulmonary disease exacerbation. It can be delivered safely in any dedicated setting, from emergency rooms to high dependency or intensive care units and wards. NIV helps improving dyspnea and gas exchange, reduces the need for endotracheal intubation, and morbidity and mortality rates. It is therefore recognized as the gold standard in this condition. High-flow nasal therapy helps improving ventilatory ef...
Source: Seminars in Respiratory and Critical Care Medicine - July 27, 2020 Category: Respiratory Medicine Authors: Ferrer, Miquel Torres, Antoni Tags: Review Article Source Type: research