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Treatment Management in Acute Exacerbation of COPD in the Emergency Department: Dilemma in Oxygen Therapy

Year 2020, Volume: 4 Issue: 2, 23 - 29, 15.12.2020

Abstract

In this study, we aimed to compare the effectiveness of jet nebulizer and oxygen supply connected to the central system with a mask in the treatment of acute exacerbation of chronic obstructive pulmonary disease (COPD). A randomized, prospective, single-center clinical trial was conducted on patients admitted to the emergency department for acute exacerbation of COPD, diagnosed with guidelines provided by Global Initiative for Chronic Obstructive Lung Disease. The patients were randomized into two groups; the first group was applied treatment with jet-nebulizer, and the second group treatment applied with oxygen supply connected to the central system. Vital signs and arterial blood gas parameters were investigated. The mean age of the included 167 patients was 69.9±10 and 66% of them were male. In terms of the effectiveness of the treatments, the respiratory rate, among the vital signs, and pCO2, among the blood gas parameters were statistically decreased in the nebulizer group. Moreover, pO2 and sO2 levels were statistically increased in the nebulizer treatment group compared to the other group. It was found that patients' blood gas parameters significantly improved in treatments applied with nebulizers. Nebulizers should be preferred in the emergency department for the treatment of acute exacerbation of COPD.

References

  • [1] Balkissoon R. Journal Club—COPD2020 Update. Global Initiative for Chronic Obstructive Lung Disease 2020 Report and the Journal of the COPD Foundation Special Edition, Moving to a New Definition for COPD:“COPDGene® 2019”. Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation (2020) 7(1):64.
  • [2] GOLD. Global Strategy for the Dignosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease (2020).
  • [3] Rothnie KJ, Müllerová H, Smeeth L, Quint JK. Natural History of Chronic Obstructive Pulmonary Disease Exacerbations in a General Practice-based Population with Chronic Obstructive Pulmonary Disease. American Journal of Respiratory and Critical Care Medicine (2018) 198(4):464–471.
  • [4] Lim S, Lam DC, Muttalif AR, Yunus F, Wongtim S, Lan le TT, et al. Impact of chronic obstructive pulmonary disease (COPD) in the Asia-Pacific region: the EPIC Asia population-based survey. Asia Pacific Family Medicine (2015) 14(1):4.
  • [5] Riley CM, Sciurba FC. Diagnosis and Outpatient Management of Chronic Obstructive Pulmonary Disease: A Review. JAMA: The Journal of the American Medical Association (2019) 321(8):786–797. doi:10.1001/jama.2019.0131.
  • [6] National Institute for Health and Care Excellence: Clinical Guidelines. In: Chronic obstructive pulmonary disease in over 16s: Tekin et al. / Treatment Management in Acute Exacerbation of COPD in the Emergency Department: Dilemma in Oxygen Therapy 29 diagnosis and management. London: National Institute for Health and Care Excellence (UK). Copyright © NICE 2018 (2019).
  • [7] Soler-Cataluna JJ, Martínez-García MÁ, Sánchez PR, Salcedo E, Navarro M, Ochando R. Severe acute exacerbations and mortality in patients with chronic obstructive pulmonary disease. Thorax (2005) 60(11):925–931.
  • [8] Singh D, Agusti A, Anzueto A, Barnes PJ, Bourbeau J, Celli BR, et al. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease: the GOLD science committee report 2019. European Respiratory Journal (2019) 53(5).
  • [9] Carvalho TC, McConville JT. The function and performance of aqueous aerosol devices for inhalation therapy. Journal of Pharmacy and Pharmacology (2016) 68(5):556–578. doi:10.1111/jphp.12541.
  • [10] Dudukcu FT, Arslan FT. Drug application with nebulizer in children; problems and solutions. Gümüşhane University Journal of Health Sciences (2016) 5(4):71–77.
  • [11] Duffy SP, Criner GJ. Chronic Obstructive Pulmonary Disease: Evaluation and Management. Medical Clinics of North America (2019) 103(3):453–461.
  • [12] Brill SE, Wedzicha JA. Oxygen therapy in acute exacerbations of chronic obstructive pulmonary disease. International journal of chronic obstructive pulmonary disease (2014) 9:1241–1252.
  • [13] Durrington HJ, Flubacher M, Ramsay CF, Howard L, Harrison BD. Initial oxygen management in patients with an exacerbation of chronic obstructive pulmonary disease. Qjm: An International Journal of Medicine (2005) 98(7):499–504.
  • [14] O’Driscoll BR, Rudenski A, Turkington PM, Howard LS. An audit of hypoxaemia, hyperoxaemia, hypercapnia and acidosis in blood gas specimens. European Respiratory Journal (2012) 39(1):219–221.
  • [15] O’Driscoll BR, Howard LS, Davison AG. BTS guideline for emergency oxygen use in adult patients. Thorax (2008) 63 Suppl 6:1–68.
  • [16] Galindo-Filho VC, Alcoforado L, Rattes C, Paiva DN, Brandão SCS, Fink JB, et al. A mesh nebulizer is more effective than jet nebulizer to nebulize bronchodilators during non-invasive ventilation of subjects with COPD: A randomized controlled trial with radiolabeled aerosols. Respiratory Medicine (2019) 153:60–67.
  • [17] Haidl P, Heindl S, Siemon K, Bernacka M, Cloes RM. Inhalation device requirements for patients’ inhalation maneuvers. Respiratory Medicine (2016) 118:65–75.
  • [18] Michotte JB, Jossen E, Roeseler J, Liistro G, Reychler G. In vitro comparison of five nebulizers during noninvasive ventilation: analysis of inhaled and lost doses. Journal of Aerosol Medicine and Pulmonary Drug Delivery (2014) 27(6):430–440.
  • [19] Cates CJ, Bestall J, Adams N. Holding chambers versus nebulisers for inhaled steroids in chronic asthma. Cochrane Database of Systematic Reviews (2006)(1): Cd001491.
  • [20] Martin AR, Finlay WH. Nebulizers for drug delivery to the lungs. Expert Opinion on Drug Delivery (2015) 12(6):889–900.
There are 20 citations in total.

Details

Primary Language English
Subjects Engineering
Journal Section Research Articles
Authors

Erdal Tekın This is me

Mustafa Bayraktar This is me

Tuğba Sanalp Menekşe This is me

Atıf Bayramoğlu This is me

Publication Date December 15, 2020
Submission Date November 7, 2020
Published in Issue Year 2020 Volume: 4 Issue: 2

Cite

APA Tekın, E., Bayraktar, M., Menekşe, T. S., Bayramoğlu, A. (2020). Treatment Management in Acute Exacerbation of COPD in the Emergency Department: Dilemma in Oxygen Therapy. International Journal of Innovative Research and Reviews, 4(2), 23-29.