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Trauma in the Elderly
Published in Ian Greaves, Keith Porter, Jeff Garner, Trauma Care Manual, 2021
Ian Greaves, Keith Porter, Jeff Garner
Supplemental oxygen should be administered if the patient is hypoxic. Care may be needed in patients with chronic lung disease.48 Early endotracheal intubation by a skilled clinician may be required if the airway is compromised.
Establishing a pulmonary rehabilitation programme
Published in Claudio F. Donner, Nicolino Ambrosino, Roger S. Goldstein, Pulmonary Rehabilitation, 2020
Michael D.L. Morgan, Sally J. Singh
Pulmonary rehabilitation is one of the most effective treatments for people with chronic lung disease. Unfortunately, only a minority of patients who would benefit are ever offered a referral to a programme. Facilities for pulmonary rehabilitation vary by country but generally programme capacity is inadequate in terms of number and size of facilities. In spite of the recognized benefits of pulmonary rehabilitation, many healthcare systems still fail to commission adequate provision. This deficiency may be due to economic constraints or lack of understanding of the benefits. This generally means that commissioners (payers) may need to be persuaded of the benefits in order to encourage them to provide a service. A good business case is necessary to demonstrate that pulmonary rehabilitation not only provides individual benefits in terms of exercise performance and quality of life but delivers good outcomes for the served population. Most commissioners will also want to appreciate that there are additional societal and health economic benefits particularly in terms of hospital admissions and possibly mortality. When making a business case it will be important to understand both the geography and the presence of inequalities in the local population.
Pulmonary Rehabilitation: Current Status and Future Trends
Published in Mary C. Singleton, Eleanor F. Branch, Advances in Cardiac and Pulmonary Rehabilitation, 2018
It is estimated that about 10 million people in the United States have some form of chronic lung disease, most frequently chronic obstructive pulmonary disease (COPD), i.e., emphysema, chronic bronchitis and asthma.2,3 There are, however, a smaller number of people with interstitial fibrosis, vascular diseases, and occupational diseases who also can be considered to have chronic lung disease.
The Promising Therapeutic Potential of Oligonucleotides for Pulmonary Fibrotic Diseases
Published in Expert Opinion on Drug Discovery, 2023
Divyani Paul, Madelyn H Miller, Josh Born, Shayak Samaddar, Huanzhen Ni, Hugo Avila, Venkata R. Krishnamurthy, Kannan Thirunavukkarasu
Pulmonary fibrosis is observed in several lung diseases such as interstitial lung diseases (ILDs), chronic asthma, chronic obstructive pulmonary disease (COPD), and cystic fibrosis (CF). Per the CDC in 2022, prior to the COVID-19 pandemic, chronic pulmonary diseases were the third leading cause of death in the US behind cardiovascular disease and neoplasms. Additionally, chronic lung disease affects over 500 million people worldwide, and is increasing in prevalence [1]. Particularly, interstitial lung diseases (ILDs) which result in pulmonary fibrosis have significant unmet needs; in 2019, over 600,000 Americans were diagnosed with ILDs. The most extensively studied and aggressive form of ILD, idiopathic pulmonary fibrosis (IPF), has a poor prognosis and a median survival of 3–5 years if left untreated [2]. Thus, fibrotic pulmonary diseases represent a significant global disease burden, and increased efforts should be made to understand the pathogenesis of these diseases and to find novel treatment strategies and drug delivery systems.
Coexistence of clinically significant obstructive sleep apnea with physician-diagnosed asthma or chronic obstructive pulmonary disease: A population study of prevalence and mortality
Published in Canadian Journal of Respiratory, Critical Care, and Sleep Medicine, 2022
Tetyana Kendzerska, Marcus Povitz, Xue Bai, Smita Pakhale, Shi Wu Wen, Andrea S. Gershon
Given that treatment for OSA may improve all-cause mortality in individuals with coexisting OSA and chronic lung disease,19 health professionals must be vigilant and consider the diagnosis of OSA in individuals with COPD or asthma of longer duration with poor control and increased severity or those who have shared risk factors such as obesity, chronic nasal conditions and gastro-esophageal reflux, especially in younger and middle-age individuals and in women. Behavioral modifications, including smoking cessation, exercise programs, dietary alteration and therapeutic compliance, may also be beneficial for both OSA and coexisting chronic lung disease.68 Furthermore, in individuals with coexisting OSA and chronic lung disease who also frequently suffer from insomnia, respiratory depressing sedatives (eg, benzodiazepines) should be avoided.69,70 Thus, including a comprehensive sleep history, including sleep hygiene and OSA, may improve the management of patients with chronic lung disease.
Interval aerobic exercise in individuals with advanced interstitial lung disease: a feasibility study
Published in Physiotherapy Theory and Practice, 2021
Lisa Wickerson, Dina Brooks, John Granton, W. Darlene Reid, Dmitry Rozenberg, Lianne G. Singer, Sunita Mathur
During aerobic exercise, acute responses in ILD include tachypnea, ventilation/perfusion mismatching, diffusion limitation, hypoxemia, increased pulmonary arterial pressure and reliance on anaerobic metabolism (Agusti et al, 1991; Hansen and Wasserman, 1996). These cardio-respiratory responses and accompanying symptoms (i.e. dyspnea and leg fatigue) may impact the feasibility of exercise in terms of a decreased ability to exercise at a prescribed workload, unintended breaks and early termination of exercise. Aerobic exercise is primarily prescribed using constant load endurance training in people with chronic lung disease. Interval exercise, defined as repeated bouts of higher intensity exercise interspersed with pre-defined recovery periods of rest or lighter intensity exercise, has been suggested as an alternative exercise strategy. Interval exercise can impose a high load to the peripheral muscles with a reduced reliance on anaerobic metabolism and lower blood lactate accumulation (Astrand and Rodahl, 1986; Billat, 2001).