Physiotherapy Management of Copd Exacerbations

Abstract

Physiotherapy remains an important tool in the treatment of cronic obstructive pulmonary disease (COPD) and especially when this disease presents exacerbations that lead to hospitalize our patients. In this article we will analyze how the physiotherapist can help these patients through respiratory therapy using, non-invasive ventilation (NIV), positioning, aerosol therapy, humidification and assistance in fibroboncoscopy.Airflow limitation is usually progressive and associated with an abnormal inflammatory response of the lungs to noxious particles or gases [1]. The global initiative for chronic obstructive lung disease is a global entity that published in 2001 a consensus and global strategy reports for the diagnosis and prevention of cronic obstructive pulmonary disease (COPD). The reports published in 2013, 2014, 2015 and 2017 were based on the scientific literature published since 2011, but maintain the same paradigm of treatment. Only in 2015 the Global Initiative for Chronic Obstructive Lung Disease (GOLD) and The Global Initiative for Asthma (GINA) approved the agreements prepared by a scientific committee for the management of Asthma and COPD overlap syndrome. Now we can see that COPD defintion until 2017 has been change progressively in the limitation of the air flow and that is associated to an unexpected inflammatory answer of lungs caused by gases or noxious particles.COPD is a common, preventable and treatable disease that is characterized by persistent respiratory symptoms and airflow limitation that is caused by airway and/or alveolar abnormalities usually caused by signicant exposure to noxious particles or gases2.Since the definition of GOLD 2017, they acknowledge that it is an abnormal inflammatory response and define it as a frequent, prevenible and treatable disease. It is also characterized by persistent respiratory symptoms and by limitation of air flow, kept from the previous definition. Also defines that this limitation must result in anomalies in the respiratory and alveolar airways caused by exposure to particles and harmful agents. This definition is roughly similar but should clarify that COPD is associated with an inflammatory response, that is a thing of the past.