Treatment of Acute Exacerbations in Chronic Obstructive Pulmonary Disease

Kunadharaju, Rajesh; Sethi, Sanjay

doi:10.1016/j.ccm.2020.06.008

Cited by 13 publications

(15 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It not only seriously affects the quality of life of patients, but also imposes a heavy economic burden on families, medical systems and society. 3 , 4 …”

Section: Introductionmentioning

confidence: 99%

“…It not only seriously affects the quality of life of patients, but also imposes a heavy economic burden on families, medical systems and society. 3,4 Non-invasive ventilation (NIV) is the preferred initial mode of ventilator assistance for patients with acute hypercapnic breathing failure caused by AECOPD. 5,6 Compared with invasive mechanical ventilation (IMV), AECOPD patients treated with NIV has lower in-hospital mortality, shorter hospital stay and lower cost.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

High-Flow Nasal Cannula Oxygen Therapy versus Non-Invasive Ventilation for AECOPD Patients After Extubation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Feng¹,

Zhang²,

Yu³

et al. 2022

COPD

View full text Add to dashboard Cite

Objective To evaluate the clinical efficacy of high-flow nasal oxygen therapy (HFNC) and non-invasive ventilation (NIV) in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) after extubation. Research Methods This systematic review and meta-analysis was conducted following the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) statements. The primary outcome measures analyzed included: reintubation rate, mortality, complication rate, and ICU length of stay. Results Eight studies were included, with a total of 612 subjects, including 297 in the HFNC group and 315 in the NIV group. The effect of HFNC and NIV on the reintubation rate of AECOPD patients after extubation, RR (1.49 [95% CI,0.95 to 2.33], P = 0.082). Subgroup analysis with or without hypercapnia according to the included AECOPD population, with hypercapnia, RR (0.69 [95% CI,0.33 to 1.44], P=0.317), without hypercapnia, RR (2.61 [95% CI,1.41 to 4.83], P=0.002). Mortality, RR (0.92 [95% CI,0.56 to 1.52], P = 0.752). ICU length of stay, MD (−0.44 [95% CI,-1.01 to 0.13], P = 0.132). Complication rate, RR (0.22 [95% CI,0.13 to 0.39], P = 0.000). After subgroup analysis, the reintubation rate of HFNC and NIV has no statistical difference in patients with hypercapnia, but NIV can significantly reduce the reintubation rate in patients without hypercapnia. In the outcome measures of complication rate, HFNC significantly reduced complication rate compared with NIV. In mortality and ICU length of stay, analysis results showed that HFNC and NIV were not statistically different. Conclusion According to the available evidence, the application of HFNC can be used as an alternative treatment for NIV after extubation in AECOPD patients with hypercapnia, but in the patients without hypercapnia, HFNC is less effective than NIV.

show abstract

“…It not only seriously affects the quality of life of patients, but also imposes a heavy economic burden on families, medical systems and society. 3 , 4 …”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

High-Flow Nasal Cannula Oxygen Therapy versus Non-Invasive Ventilation for AECOPD Patients After Extubation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Feng¹,

Zhang²,

Yu³

et al. 2022

COPD

View full text Add to dashboard Cite

show abstract

“…In this regard, noninvasive ventilation has greatly decreased the mortality in exacerbations that require ventilatory support. However, across the range of exacerbation severity, treatment failure and relapses are frequent [35].…”

Section: Exacerbation Triggersmentioning

confidence: 99%

Air Pollution Exposure as a Relevant Risk Factor for COPD Exacerbations in Male and Female Patients

Rodriguez¹,

Silveyra²

2021

Preprint

View full text Add to dashboard Cite

Chronic obstructive pulmonary disease (COPD) is a multifactorial lung inflammatory disease affecting 174 million people worldwide, with a recently reported increased incidence in female patients. Patients with COPD are especially vulnerable to the detrimental effects of environmental exposures, especially from air particulate and gaseous pollutants. Exposure to air pollution severely influences COPD outcomes, resulting in acute exacerbations, hospitalizations, and death. In the current study, we conducted a review of the literature addressing air pollution induced acute exacerbations of COPD (AECOPD) in order to determine whether air pollution affects COPD patients in a sex-specific manner. We found that while the majority of studies enrolled both male and female patients, only a few reported results disaggregated by sex. Most studies had a higher enrollment of male patients, only four compared AECOPD outcomes between sexes, and only one study identified sex differences in AECOPD, with females displaying higher rates. Overall, our analysis of the literature confirmed that air pollution exposure is a trigger for AECOPD hospitalizations and revealed a significant gap in our knowledge of sex-specific effects of air pollutants on COPD outcomes, highlighting the need for more studies considering sex as a biological variable.

show abstract

“…8 The cornerstone of pharmacotherapy for stable COPD is long-acting bronchodilators or combined with inhaled corticosteroids (ICS), while the treatment for AECOPD also includes antiinfective drugs. 9 The treatment strategies will be more complicated especially for patients with complex complications. Thus, the selection of drugs with different mechanisms and the pharmaceutical care will be of great importance in the management of COPD.…”

Section: Introductionmentioning

confidence: 99%

Chronic Obstructive Pulmonary Disease Treatment and Pharmacist-Led Medication Management

Li¹,

Han²,

Zhang³

et al. 2021

DDDT

View full text Add to dashboard Cite

Treatment of Acute Exacerbations in Chronic Obstructive Pulmonary Disease

Cited by 13 publications

References 45 publications

High-Flow Nasal Cannula Oxygen Therapy versus Non-Invasive Ventilation for AECOPD Patients After Extubation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

High-Flow Nasal Cannula Oxygen Therapy versus Non-Invasive Ventilation for AECOPD Patients After Extubation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Air Pollution Exposure as a Relevant Risk Factor for COPD Exacerbations in Male and Female Patients

Chronic Obstructive Pulmonary Disease Treatment and Pharmacist-Led Medication Management

Contact Info

Product

Resources

About