Respiration; international review of thoracic diseases
-
Chronic obstructive pulmonary disease (COPD) is one of the leading causes of death in the US. Numerous studies have demonstrated that sleep disturbances are common in COPD patients, with more prominent complaints in patients with more severe disease and with increasing age. Sleep disturbances may occur due to the effects of breathing abnormalities on sleep and sleep disruption. ⋯ Treatment includes use of nocturnal oxygen therapy, noninvasive positive pressure ventilation, and long-acting medications. There has been little study on improving sleep quality beyond treating the respiratory disease, despite the fact that numerous studies show poor sleep quality, a high prevalence of insomnia, and tolerability of newer hypnotic agents in the setting of COPD. This article defines the scope of sleep problems in the setting of COPD, reviews the impact of sleep on ventilation, explores the role of obstructive sleep apnea in the setting of COPD, and reviews therapeutic options.
-
Controlled Clinical Trial
Oxygen consumption, shuttle walking test and the evaluation of lung resection.
Assessment of peak oxygen uptake (VO(2)) is recommended in the evaluation of patients with borderline pulmonary function as VO(2) is the strongest independent predictor of postoperative pulmonary complications. However, the measurement of VO(2) requires expensive equipment not available in many medical facilities. The shuttle walking test (SWT) has been proposed to be used as a screening tool prior to performing a cardiopulmonary exercise test. Although an association exists between SWT distance and VO(2), only one small study directly measured VO(2) during the SWT. ⋯ Our findings validate the association between VO(2) and SWT distance and facilitate the interpretation of the test in general practice, particularly when deciding the candidacy of a patient for surgical resection.
-
Ambulatory oxygen is frequently prescribed for patients with chronic obstructive pulmonary disease (COPD) who have oxygen desaturation
-
Bronchopulmonary dysplasia (BPD) refers to a heterogeneous group of lung disorders in infants that is commonly associated with prematurity and surfactant deficiency. BPD results from the complex interplay between impairments in the premature lung such as surfactant deficiency, perinatal insults such as infection, and damage resulting from supportive care of the infant due to barotrauma or volutrauma from mechanical ventilation and oxygen toxicity from supplemental oxygen administration. ⋯ The term 'new' BPD is now commonly used, to describe the changes seen in the post-surfactant era. This discussion reviews the pathogenesis of BPD according to the current medical literature.