Acute Exacerbation of Chronic Obstructive Lung Disease: Etiology and Treatment.

Yıl 2014, Cilt: 4 Sayı: 4, 164 - 170, 01.12.2014

Yusuf Aydemir

https://doi.org/10.5505/sakaryamj.2014.77486

Öz

Both worldwide and in our country, the increasing incidence of Chronic Obstructive Pulmonary Disease (COPD) is a major health problem. Acute exacerbations, which are a major cause of emergency room visits and hospital admissions, are the largest component of this problem. Acute exacerbations adversely affect the prognosis of the disease and accelerate the process, resulting in severe respiratory failure, and are a cause of morbidity/mortality. Moreover, they cause a considerable load on healthcare expenditures and a significant amount of labor force loss. The etiology and treatment of exacerbations especially must be well understood by family and emergency service physicians, home health care service providers, and physicians dealing with chest diseases.

Anahtar Kelimeler

Chronic Obstructive Pulmonary Disease, COPD, etiology of exacerbation, treatment of exacerbation.

Kronik Obstrüktif Akciğer Hastalığında Akut Alevlenme: Etyoloji ve Tedavi

Öz

Kronik obstrüktif Akciğer Hastalığı (KOAH), tüm dünyada ve ülkemizde sıklığı giderek artan bir küresel sağlık sorunudur. Acil servis başvuruları ve hastane yatışlarının önemli bir nedeni olan akut alevlenmeler, bu sorunun en büyük bileşenidir. Akut alevlenmeler, ağır solunum yetmezliğine gidiş sürecini hızlandırır, yüksek oranda mortalite ve morbidite nedenidir ve ülkelerin sağlık harcamalarında ciddi bir yük oluşturur. Alevlenmelerin etyolojisi ve tedavisi özellikle acil servis-aile hekimleri, evde sağlık hizmeti sunucuları ve göğüs hastalıkları ile ilgilenen hekimlerce iyi bilinmelidir.

Anahtar Kelimeler

Kronik Obstrüktif Akciğer Hastalığı, KOAH, akut alevlenme etyolojisi, akut alevlenme tedavisi

Kaynakça

• Global Strategy for the Diagnosis, Management and Prevention of COPD, Global Initiative for Chronic Obstructive Lung Disease (GOLD). http://www. goldcopd.org/guidelines-global-strategy-for-diagnosis-management.html (accessed: 20 September 2013).
• World Healh Organization, http://apps.who.int/gho/data/node.main. CODWORLD?lang=en (accessed: 20 September 2013).
• Murray CJ, Lopez AD. Alternative projections of mortality and disability by cause 1990-2020: Global Burden of Disease Study. Lancet. 1997;349:1498- 504.
• Hilleman DE, Dewan N, Malesker M, Friedman M. Pharmacoeconomic evaluation of COPD. Chest2000;118:1278-1285
• Miravittles M. Epidemiology of Chronic obstructive pulmonary disease exacerbations. Clin Pulm. Med. 2002;9:191-197
• Wedzicha JA, Donaldson GC. Exacerbations of chronic obstructive pulmonary disease. Respir Care. 2003;48:1204-13
• Mannino DM, McBurnie MA, Tan W, Kocabas A, Anto J, Vollmer WM, et al. Restricted spirometry in the Burden of Lung Disease Study. Int J Tuberc Lung Dis. 2012;16:1405-11.
• Anthonisen NR, Manfreda J, Warren CP, et al. Antibiotic therapy in exacerbation of chronic obstructive pulmonary disease. Ann Intern Med1987;106:196-204
• O’Reilly CF, Williams AE, Holt K, et al. Defining COPD exacerbations: impact on estimation of incidence and burden in primary care. Primary Care Respiratory Journal 2006;15:346-353
• Hurst JR, Vestbo J, Anzueto A. Susceptibility to exacerbation in chronic obstructive pulmonary disease. N Engl J Med. 2010;363:1128-38
• Sethi S, Murphy TF. Infection in the pathogenesis and course of chronic obstructive pulmonary disease. N Engl J Med. 2008;359:2355-65.
• Hacıevliyagil SS, Günen H, Mutlu LC, Gülbaş G. The causes of exacerbations in patients with chronic obstructive pulmonary disease. Solunum Hastalıkları 2006;17:8-12
• Patel IS, Seemungal TA, Wilks M, et al. Relationship between bacterial colonisation and the frequency, character, and severity of COPD exacerbations. Thorax. 2002;57:759-64.
• Nseir S, Cavestri B, Di Pompeo C, Diarra M, Brisson H, Lemyze M, et al. Factors predicting bacterial involvement in severe acute exacerbations of chronic obstructive pulmonary disease. Respiration. 2008;763:253-60.
• Miravitlles M, Espinosa C, Fernández-Laso E, Martos JA, Maldonado JA, Gallego M. Relationship between bacterial flora in sputum and functional impairment in patients with acute exacerbations of COPD. Study Group of Bacterial Infection in COPD. Chest. 1999;116:40-6.
• Eller J, Ede A, Schaberg T, Niederman MS, Mauch H, Lode H. Infective exacerbations of chronic bronchitis: relation between bacteriologic etiology and lung function. Chest. 1998;113:1542-8.
• Li XJ, Li Q, Si LY, Yuan QY. Bacteriological differences between COPD exacerbation and community-acquired pneumonia. Respir Care. 2011;56:1818-24.
• Brumfıtt W, Wılloughby Ml, Bromley LL. An evaluation of sputum examination in chronic bronchitis. Lancet. 1957;270:1306-9.
• Zhang M, Li Q, Zhang XY, Ding X, Zhu D, Zhou X.. Relevance of lower airway bacterial colonization, airway inflammation, and pulmonary function in the stable stage of chronic obstructive pulmonary disease. Eur J Clin Microbiol Infect Dis. 2010;29:1487-93.
• Cabello H, Torres A, Celis R, El-Ebiary M, Puig de la Bellacasa J, Xaubet A, et al. Bacterial colonization of distal airways in healthy subjects and chronic lung disease: a bronchoscopic study. Eur Respir J. 1997;10:1137-44.
• Rosell A, Monsó E, Soler N, Torres F, Angrill J, Riise G, et al. Microbiologic determinants of exacerbation in chronic obstructive pulmonary disease. Arch Intern Med. 2005; 25;165(8):891-7
• Garcha DS, Thurston SJ, Patel AR, Mackay AJ, Goldring JJ, Donaldson GC, et al. Changes in prevalence and load of airway bacteria using quantitative PCR in stable and exacerbated COPD. Thorax. 2012;67:1075-80.
• Veeramachaneni SB, Sethi S. Pathogenesis of bacterial exacerbations of COPD. COPD. 2006;3:109-15.
• Perotin JM, Dury S, Renois F, Deslee G, Wolak A, Duval V, et al. Detection of multiple viral and bacterial infections in acute exacerbation of chronic obstructive pulmonary disease: a pilot prospective study. J Med Virol. 2013;85:866-73
• Mohan A, Chandra S, Agarwal D, Guleria R, Broor S, Gaur B,et al. Prevalence of viral infection detected by PCR and RT-PCR in patients with acute exacerbation of COPD: a systematic review. Respirology. 2010 Apr;15(3):536-42.
• Boixeda R, Rabella N, Sauca G, Delgado M, Martínez-Costa X, Mauri M, et al. Microbiological study of patients hospitalized for acute exacerbation of chronic obstructive pulmonary disease (AE-COPD) and the usefulness of analytical and clinical parameters in its identification (VIRAE study). Int J Chron Obstruct Pulmon Dis. 2012;7:327-35.
• Mogulkoc N, Karakurt S, Isalska B, Bayindir U, Celikel T, Korten V, et al. Acute purulent exacerbation of chronic obstructive pulmonary disease and Chlamydia pneumoniae infection. Am J Respir Crit Care Med. 1999;160:349-53.
• Uzun K, Özbay B, Buzgan T, Zehir İ, Evigen Ö, Andiç Ş, et al. Prevalance of Chlamydia pneumoniae, Mycoplasma pneumoniae, Legionella spp. and Influenza A in COPD Acute Exacerbation. Turkish Thoracic Journal. 2002;3:146-150
• Güldaval F, Evciler İ, Şenol G, Özacar R. The role of viruses and atypical agents in acute exacerbations of COPD. İzmir Göğüs Hastanesi Dergisi.2005;19:45-50
• Taşbakan SM, Sayıner AA, Sayıner A. Role of atypical pathogens in infectious exacerbations of COPD. Tuberculosis and Thorax. 2007;55:336-341.
• Strålin K, Korsgaard J, Olcén P. Evaluation of a multiplex PCR for bacterial pathogens applied to bronchoalveolar lavage. Eur Respir J. 2006;28:568- 75.
• Huang YJ, Kim E, Cox MJ, Brodie EL, Brown R, Wiener-Kronish JP, et al. A persistent and diverse airway microbiota present during chronic obstructive pulmonary disease exacerbations. OMICS. 2010;14:9-59.
• Aydemir Y. Relationship between the gold combined COPD assessment staging system and bacterial isolation. Turkish Respiratory Society, 35. Annual Meeting "Solunum 2013". SS-038
• Akın B, Tülek B, Arslan U, Sütçü L, Fındık D, Süerdem M. Quantitative detection of Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis on sputum in exacerbations of chronic obstructive pulmonary disease by real-time PCR. Solunum. 2011;13:32-40
• Diederen BM, van der Valk PD, Kluytmans JA, Peeters MF, Hendrix R. The role of atypical respiratory pathogens in exacerbations of chronic obstructive pulmonary disease. Eur Respir J. 2007;30:240-4.
• Başoğlu Ö,K, Sayıner A,A, Zeytinoğlu A, Sayıner A. The role of atypical bacteria in acute exacerbations of chronic obstructive pulmonary disease. TRJ. 2005;6:22-7.
• Ling SH, van Eeden SF. Particulate matter air pollution exposure: role in the development and exacerbation of chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis. 2009;4:233-43.
• Peacock JL, Anderson HR, Bremner SA, Marston L, Seemungal TA, Strachan DP, et al. Outdoor air pollution and respiratory health in patients with COPD. Thorax. 2011 Jul;66(7):591-6.
• Erk M. KOAH Alevlenmesi. Solunum. 2003;5:285-290
• Stockley RA, O'Brien C, Pye A, Hill SL. Relationship of sputum color to nature and outpatient management of acute exacerbations of COPD. 2000. Chest. 2009;136(5 Suppl):e30.
• Ram FS, Rodriguez-Roisin R, Granados-Navarrete A, Garcia-Aymerich J, Barnes NC. Antibiotics for exacerbations of chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2006:19;(2):CD004403.
• Quon BS, Gan WQ, Sin DD. Contemporary management of acute exacerbations of COPD: a systematic review and metaanalysis. Chest. 2008 Mar;133(3):756-66
• Türk Toraks Derneği, Akut Bronşit ve KOAH ve Bronşektazi Alevlenmelerinde Antibiyotik Tedavisi Uzlaşı Raporu. Turkish Thoracic Journal. 2009; 10, supp. 7:1-7.
• Aydemir Y. Misuse of Inhalation Devices; Effective Parameters and the Role of Education. Solunum. 2013;15:32-38
• Bateman NT, Leach RM. ABC of oxygen. Acute oxygen therapy. BMJ. 1998 Sep 19;317(7161):798-801.