An impact of comprehensive pulmonary physiotherapy on ABG level and early functional independence in the patient with acute COPD exacerbation with CO2 narcosis

Abstract

Chronic obstructive pulmonary disease (COPD) is a chronic illness characterized by an acute exacerbation of respiratory symptoms. Recurrent episodes of acute exacerbation result in acute hypercapnia and acute carbon dioxide narcosis, which are often accompanied byan altered level of consciousness. Acute exacerbations in the elderly have a worse outcome, as evidenced by an increase in comorbid illnesses, length of stay, rehospitalization rate, and death rate. This article describes the case of an elderly female patient who presented to the emergency unit with complaints of altered conscious state, dyspnea, cough with expectoration, fever, loss of appetite, and abdominal pain. Her ABG tests also revealed a low pH and an abnormal level of blood gases with acute hypercapnia. The patient was admitted to the medical ICU with ventilator assistance as well as medications, but to restore the patient's respiratory capacity and improve the patient's quality of life, a complete physiotherapy management plan was implemented for four weeks. The treatment primarily aimed at stabilizing ABG levels using integrated physiotherapy approaches and thereby improving the patient's medical state. The patient's improvement was measured in the outcomes of ABG levels, COPD assessment test score, Peak expiratory flow rate, FIM scores, dyspnea levels, and walking distance over four weeks, demonstrating the effectiveness of the treatment.