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By Jason Mann No BS pulmonary critical care fellow
Martin I MacDonald, Eskandarain Shafuddin, Paul T King, Catherina L Chang, Philip G Bardin, Robert J Hancox
Chronic obstructive pulmonary disease (COPD) and cardiovascular disease often coexist, and acute cardiac events frequently occur during COPD exacerbations. Even when cardiac complications are not clinically apparent, biochemical evidence of cardiac dysfunction is often noted during exacerbations and portends poor prognosis. Diagnosis of cardiac disease in COPD can be difficult and necessitates a high degree of clinical suspicion. However, the additional strain of an exacerbation could be a pivotal moment, during which previously unsuspected cardiac dysfunction is exposed...
February 2016: Lancet Respiratory Medicine
Tricia M McKeever, Glenn Hearson, Gemma Housley, Catherine Reynolds, William Kinnear, Tim W Harrison, Anne-Maree Kelly, Dominick E Shaw
INTRODUCTION: Identifying acute hypercapnic respiratory failure is crucial in the initial management of acute exacerbations of COPD. Guidelines recommend obtaining arterial blood samples but these are more difficult to obtain than venous. We assessed whether blood gas values derived from venous blood could replace arterial at initial assessment. METHODS: Patients requiring hospital treatment for an exacerbation of COPD had paired arterial and venous samples taken...
March 2016: Thorax
Gavin C Donaldson, Martin Law, Beverly Kowlessar, Richa Singh, Simon E Brill, James P Allinson, Jadwiga A Wedzicha
RATIONALE: Exacerbations are important and heterogeneous events in the natural history of chronic obstructive pulmonary disease (COPD). OBJECTIVES: To examine the consequences of prolonged exacerbation recovery in patients with COPD. METHODS: A cohort of 384 patients with COPD (FEV1 % predicted 45.8 [SD, 16.6] and a median exacerbation rate of 2.13 per year [interquartile range, 1.0-3.2]) were followed for 1,039 days (interquartile range, 660-1,814) between October 1995 and January 2013...
October 15, 2015: American Journal of Respiratory and Critical Care Medicine
Philip M Short, Samuel I W Lipworth, Douglas H J Elder, Stuart Schembri, Brian J Lipworth
OBJECTIVE: To examine the effect of β blockers in the management of chronic obstructive pulmonary disease (COPD), assessing their effect on mortality, hospital admissions, and exacerbations of COPD when added to established treatment for COPD. DESIGN: Retrospective cohort study using a disease specific database of COPD patients (TARDIS) linked to the Scottish morbidity records of acute hospital admissions, the Tayside community pharmacy prescription records, and the General Register Office for Scotland death registry...
May 10, 2011: BMJ: British Medical Journal
Negin Hajizadeh, Keith Goldfeld, Kristina Crothers
We performed a retrospective cohort study of patients with chronic obstructive lung disease (COPD) on long-term oxygen treatment (LTOT) who received invasive mechanical ventilation for COPD exacerbation. Of the 4791 patients, 23% died in the hospital, and 45% died in the subsequent 12 months. 67% of patients were readmitted at least once in the subsequent 12 months, and 26.8% were discharged to a nursing home or skilled nursing facility within 30 days. We conclude that these patients have high mortality rates, both in-hospital and in the 12 months postdischarge...
March 2015: Thorax
Fernando J Martinez, Peter M A Calverley, Udo-Michael Goehring, Manja Brose, Leonardo M Fabbri, Klaus F Rabe
BACKGROUND: Roflumilast reduces exacerbations in patients with severe chronic obstructive pulmonary disease. Its effect in patients using fixed combinations of inhaled corticosteroids and longacting β2 agonists is unknown. We postulated that roflumilast would reduce exacerbations in patients with severe chronic obstructive pulmonary disease at risk for exacerbations, even in combination with inhaled corticosteroid and longacting β2 agonist treatment. METHODS: For this 1-year double-blind, placebo-controlled, parallel group, multicentre, phase 3-4 trial, the Roflumilast and Exacerbations in patients receiving Appropriate Combination Therapy (REACT) study, we enrolled patients with severe chronic obstructive pulmonary disease from 203 centres (outpatient clinics, hospitals, specialised pulmonologists, and family doctors) in 21 countries...
March 7, 2015: Lancet
Clare L Ross, Trevor T Hansel
Clinical trials with new drugs for chronic obstructive pulmonary disease (COPD) have been performed. Viruses exacerbate COPD and bacteria may play a part in severe COPD; therefore, antibiotic and antiviral approaches have a sound rationale. Antiinflammatory approaches have been studied. Advances in understanding the molecular basis of other processes have resulted in novel drugs to target reactive oxidant species, mucus, proteases, fibrosis, cachexia, and muscle wasting, and accelerated aging. Studies with monoclonal antibodies have been disappointing, highlighting the tendency for infections and malignancies during treatment...
March 2014: Clinics in Chest Medicine
Andrea S Gershon, Michael A Campitelli, Ruth Croxford, Matthew B Stanbrook, Teresa To, Ross Upshur, Anne L Stephenson, Thérèse A Stukel
IMPORTANCE: Chronic obstructive pulmonary disease (COPD), a manageable respiratory condition, is the third leading cause of death worldwide. Knowing which prescription medications are the most effective in improving health outcomes for people with COPD is essential to maximizing health outcomes. OBJECTIVE: To estimate the long-term benefits of combination long-acting β-agonists (LABAs) and inhaled corticosteroids compared with LABAs alone in a real-world setting...
September 17, 2014: JAMA: the Journal of the American Medical Association
John J Reilly
No abstract text is available yet for this article.
October 2, 2014: New England Journal of Medicine
Nicola A Hanania
No abstract text is available yet for this article.
April 2014: Annals of Thoracic Medicine
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