The Clinical Implications of Carbon Dioxide Increased Level in Arterial Blood Related to Severe Exacerbations of Chronic Obstructive Pulmonary Disease

Introduction. Anxiety and depression are frequently associated conditions in COPD patients, and have also significant impact on their quality of life (QoL) and on the course of the disease. Pulmonary rehabilitation (PR) is an adjuvant, non-pharmacological method used in symptomatic COPD patients. The study aimed to evaluate the impact of COPD on QoL depending on disease severity, and to assess the supposedly positive effects of a pulmonary rehabilitation program (PRP) for COPD patients. Material and method. This research included patients with COPD GOLD stages II-IV undergoing bronchodilator therapy. QoL was assessed with the self-administered St George's Respiratory Questionnaire (SGRQ), and depression with the Beck Depression Inventory (BDI). PRP included 3-5 weekly physical training sessions for an average period of 12 weeks, but not less than 3 weeks. Results. The degree of QoL impairment was moderate in stage II (41.07) and severe in stages III (70.28) and IV (81.02). The most severe depression (score 26.6 vs 2.5 in healthy subjects) was also recorded in this group. After the patients underwent all PRP, QoL reassessment at 6 months revealed statistically significant improvements in all 3 groups (p <0.05). In the GOLD COPD stage II group the average reduction was-4.38 units, in the group GOLD COPD stage III-5.37 units, and in the GOLD COPD stage IV-6.75 units. The depression score correlated with the SGRQ score, both of them being higher in the severe stages of disease. BDI administered again 6 months after PRP revealed a significant improvement in average score in all groups, respectively a decrease of-2.17 units in the COPD II group,-2.03 units in the COPD III group and-1.88 units in group COPD IV B group. Conclusion. The results of this study demonstrate a favorable impact of PRP on improving COPD associated symptoms, depression, and QoL in all the 3 monitored COPD patient groups, with statistically significant and persistent positive results over time (6 months after completion of PRP).

Section: Resultsmentioning

confidence: 99%

Untitled

2019

“…Pulmonary rehabilitation is a well-proven complex and multidisciplinary treatment approach that includes patient evaluation and education, smoking cessation intervention, physical training and skeletal muscle strengthening, nutritional intervention, occupational therapy and psychosocial support (25). A PR program should be included into a personalized management plan, along with pharmacological therapy (26,27) and long term oxygen therapy when needed (28,29). Patients who should benefit the most from a PR program are COPD patients from groups B−D, according to the Global initiative for Obstructive Lung Disease (GOLD) guidelines (30).…”

Section: Methodsmentioning

confidence: 99%

Cardiovascular surgery complication and the benefits of pulmonary rehabilitation in preventing COPD exacerbation

Stanciu

Axelerad

Corduneanu

et al. 2020

Self Cite

Introduction. Chronic obstructive pulmonary disease (COPD) is one of the leading causes of morbidity and mortality worldwide, and the burden of the disease is constantly increasing. Although COPD is primarily characterized by the presence of airflow obstruction, in many patients, it is associated with systemic manifestations that can result in impaired functional capacity, reduced quality of life, and increased mortality. Pulmonary rehabilitation (PR) consists of a multidisciplinary and comprehensive non-pharmacological intervention that is designed to improve health status in COPD patients, along with pharmacologic treatment. PR has also been shown to improve the diaphragmatic mobility in patients with different conditions that affect the diaphragm. The aim of the paper is to describe the clinical and functional features of a COPD patient with unilateral paralysis of the phrenic nerve and the role of PR as a major component of the case management. Material and method. This paper presents the case of a 66-year-old patient, diagnosed with COPD Gold stage III, which suffered a surgical intervention for an aorta aneurysm and later complicated with phrenic nerve injury and left diaphragmatic paralysis. This condition worsened the respiratory functional status and the patient needed a tailored treatment. Results and discussions. The treatment included besides inhaled dual long acting bronchodilator and corticoid therapy, pulmonary rehabilitation with complex methods, consisting in training of the respiratory musculature and techniques of bronchial drainage using devices with positive inspiratory and expiratory pressure, with good clinical and functional outcomes. A PR program should be included into a personalized management plan, along with pharmacological therapy. Conclusion. Although there is no standard treatment for COPD associated with unilateral paralysis of the phrenic nerve, it is important to diagnose these conditions promptly, and to recommend the adequate pharmacological treatment for controlling the symptoms along with a personalized complex respiratory rehabilitation program, in order to increase functional status and quality of life. Key words: respiratory rehabilitation, COPD, phrenic nerve paralysis

Effectiveness of pulmonary rehabilitation in improving quality of life in patients with different COPD stages

Ilie

Crişan

Stanca

et al. 2020

Introduction. Anxiety and depression are frequently associated conditions in COPD patients, and have also significant impact on their quality of life (QoL) and on the course of the disease. Pulmonary rehabilitation (PR) is an adjuvant, non-pharmacological method used in symptomatic COPD patients. The study aimed to evaluate the impact of COPD on QoL depending on disease severity, and to assess the supposedly positive effects of a pulmonary rehabilitation program (PRP) for COPD patients. Material and method. This research included patients with COPD GOLD stages II-IV undergoing bronchodilator therapy. QoL was assessed with the self-administered St George's Respiratory Questionnaire (SGRQ), and depression with the Beck Depression Inventory (BDI). PRP included 3-5 weekly physical training sessions for an average period of 12 weeks, but not less than 3 weeks. Results. The degree of QoL impairment was moderate in stage II (41.07) and severe in stages III (70.28) and IV (81.02). The most severe depression (score 26.6 vs 2.5 in healthy subjects) was also recorded in this group. After the patients underwent all PRP, QoL reassessment at 6 months revealed statistically significant improvements in all 3 groups (p <0.05). In the GOLD COPD stage II group the average reduction was -4.38 units, in the group GOLD COPD stage III -5.37 units, and in the GOLD COPD stage IV -6.75 units. The depression score correlated with the SGRQ score, both of them being higher in the severe stages of disease. BDI administered again 6 months after PRP revealed a significant improvement in average score in all groups, respectively a decrease of -2.17 units in the COPD II group, -2.03 units in the COPD III group and -1.88 units in group COPD IV B group. Conclusion. The results of this study demonstrate a favorable impact of PRP on improving COPD associated symptoms, depression, and QoL in all the 3 monitored COPD patient groups, with statistically significant and persistent positive results over time (6 months after completion of PRP). Key words: COPD, pulmonary rehabilitation program, Quality of life (QoL), depression,