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Long-term oxygen therapy (LTOT) ≥ 15 h/day improves survival in hypoxemic chronic obstructive pulmonary disease (COPD). LTOT 24 h/day is often recommended but may pose an unnecessary burden with no clear survival benefit compared with LTOT 15 h/day. The aim was to test the hypothesis that LTOT 24 h/day decreases all-cause, respiratory, and cardiova...
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... 15 Some COPD cases may also develop bacterial infections, including a number of pathogenic and non-pathogenic bacteria. 5,6,16 The effects of aerobic bacteria in COPD patients have not yet been well defined. 17 The resulting infections can play a significant role in exacerbating the symptoms of COPD. ...
... 14 For better treatment outcome a proper stratification of the bacteriological profile and treatment is required but empirical selection of antibiotics is often based on the past experience, availability of antibiotics in the hospital (government set up), cost and last but not the least -the best givers method. 15 There is a wide variation of using antibiotics as "there are no governing laws towards their rational use". Resistance was seen to many antibiotics, even for the higher antibiotics and hence MDR strains were commonly encountered. ...
Background: Most of the acute exacerbations of COPD are preventable and curable. More than 50% of them are infectious in nature and strain of the pathogen causing them is quite variable from place to place and often determines the severity of exacerbation. Antibiotic resistance has created a bigger challenge for the treating physicians to have a better treatment outcome. Our objective was to study the bacterial profile and antibiotic sensitivity pattern in all acute exacerbation of hospitalized COPD patients.Methods: All patients admitted for COPD exacerbation were evaluated for their sputum culture and sensitivity and followed up.Results: Totally 148 patients were included in the study and organisms were isolated 72 patients. Important organisms isolated were Klebsiella (20), Pseudomonas (16), Streptococci (8), Staphylococcus aureus (8), MTB (4) etc. Many MDR strains were noted. Resistance to newer antibiotics were also noted.64 patients out of 148 required a change in antibiotic (40 in culture positive group, 24 in culture negative group) and there were 12 deaths noted in study. Mortality and morbidity were more in culture negative group and in those who had MDR strains.Conclusions: Gradual shift to gram negative bacilli was observed in infective exacerbation of COPD. Multiple resistant strains were noted and often responsible for poor recovery. Early diagnosis and proper antibiotic selection is the key for a good treatment outcome.
Background: COPD exacerbations is an acute condition with worsening symptoms and require more intensive treatment changes. Increased inflammatory exacerbations marked increase in plasma levels of IL-8, exacerbation of clinical symptoms and risk of hospitalization. Ginseng extracts have anti inflammatory so it can be used as an additional drug in COPD exacerbations. Method: This study aimed to analyze the effect of ginseng extract on plasma levels of IL-8, CAT scores, and length of hospitalization of patients with COPD exacerbations. Clinical trials of experimental with pre test and post test design was conducted on 34 patients with COPD exacerbation in Dr. Moewardi Hospital Surakarta and Dr. Ario Wirawan Lung Hospital Salatiga from August until September 2016. Samples were taken by consecutive sampling were divided into two groups. The treatment group (n = 17) received standard therapy and ginseng extracts 2x100mg/day and the control group received only standard therapy (n = 17). Clinical improvement measured in CAT score and length of stay. Plasma levels of IL-8, CAT scores, and longer hospitalization time measured at entry and discharge criteria are met. Length of stay based on the number of days of care in hospitals. Results: There were significant difference (p=0.000) towards decreased of of IL-8 plasma level between treatment group (-12.38 ± 10,35pg/ml) and control group (0.65 ± 7,92pg/ml), towards decrease of CAT score (p=0.000) between treatment group (-16.53 ± 1.28) and control group (-12.59 ± 2.87), and length of stay (p = 0.004) between treatment group (4.29 ± 1.45) and control group (5.76 ± 1.20). Conclusions: The addition of ginseng extract 2x100 mg/day during hospitalization was significantly lowered plasma levels of IL-8, CAT scores, and shortening the length of stay. (J Respir Indo. 2018; 38: 192-8)
Acute respiratory failure (ARF) is defined as the inability of the respiratory system to meet the oxygenation, ventilatory, or metabolic requirements of the patient [1].
This book provides a detailed review of state of the art knowledge on critical care topics as well as the latest research findings. It covers the core aspects in excellent detail, but is not so comprehensive as to make its daily use unfeasible. For each condition considered, discussion of the pathophysiology is integrated with observations on diagnosis and treatment in order to allow a deeper understanding. The book is scientifically based, with extensive references to published research. This will allow readers to investigate their individual interests further and will enable physicians to justify measures by providing a coherent, evidence-based strategy and relevant citations where needed. Core Knowledge in Critical Care Medicine will appeal to experienced practitioners as an aide-mémoire, but will also be of great value to a wide range of more junior staff wishing to complement their background knowledge with important facts applicable to everyday practice. © Springer-Verlag Berlin Heidelberg 2014. All rights are reserved.
