Physiological abnormalities in patients admitted with acute exacerbation of COPD: an observational study with continuous monitoring

Abstract

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An Updated Definition and Severity Classification of Chronic Obstructive Pulmonary Disease Exacerbations: The Rome Proposal

“…Heart rates >85 bpm or increases in heart rates by 10-15 bpm compared to baseline were reported during an acute exacerbation (49). Respiratory rates >24 breaths per min, with shortened expiratory time leading to gas trapping, have been consistently reported in most studies conducted in hospitalized patients (51,53), whereas respiratory rates of 18-20 breaths per min were documented in patients receiving outpatient care (53). The panel reached consensus that a heart rate <95 bpm and a respiratory rate <24 breaths per min could help separate mild from moderate ECOPD.…”

“…Studies have shown that both heart rate and respiratory rate increase in the days preceding, during and following ECOPD (30,31,47,48), and are measurable by widely available noninvasive methods offering a window to the severity of the episodes (48)(49)(50)(51).…”

Continuous monitoring of vital sign abnormalities; association to clinical complications in 500 postoperative patients

“…Continuous wireless monitoring may enable high‐frequency monitoring of physiological status on general wards outside the intensive care (ICU) or post‐anesthesia care unit (PACU) without restricting early postoperative mobilization or requesting unrealistic staffing. Ongoing technological research on general wards has consistently shown continuous monitoring to be superior to track and trigger systems in detecting abnormal vital signs 16–18 …”

Procalcitonin kinetics to guide sequential invasive-noninvasive mechanical ventilation weaning in patients with acute exacerbation of chronic obstructive pulmonary disease and respiratory failure: procalcitonin’s adjunct role

“…Indwelling endotracheal intubation for mechanical ventilation can effectively dilate the airway of spastic obstruction, reduce carbon dioxide retention, improve the state of ventilation and oxygenation, and promote the rapid improvement of the patients' conditions [30]. Although invasive mechanical ventilation is the primary approach of treatment for the patients with ARF in a state of unconsciousness, it does not work well to the patients with COPD because the functions of their airway structural defense barrier would be attenuated with a higher risk of bacterial infection due to the existence of irreversible airway obstruction lesions, reduction of mucosal surface cilia, mucosal hyperemia and edema, and mucous glandular cell hyperplasia and hypertrophy [31,32]. Apart from that, since the patients with COPD are also affected by long-term malnutrition, unsatisfactory development of respiratory muscles, and abatement of physical strength, it is more likely for them to become heavily dependent on ventilators so that there is much more difficulty in taking away the assisted respiratory equipment after invasive mechanical ventilation support treatment.…”