Objectives. Objectives. Definition. Physiology. Evaluation of the Dyspneic Patient. B. Celli Disclaimer
|
|
- Augustine Shelton
- 5 years ago
- Views:
Transcription
1 Evaluation of the Dyspneic Patient Bartolome R. Celli Harvard Medical School Brigham and Women s Hospital Boston B. Celli Disclaimer No stocks or ownership in any company. No Tobacco funds No promotional talks Grants: GSK, B.I., Almirall, Novartis, Forrest, Aeris Advisory boards: GSK, B.I., Dey, Altana, Astra Zeneca, Almirall, Sepracor, Pfizer. Rox. Definition Dyspnea, shortness of breath (SOB), or air hunger, is the subjective symptom of breathlessness Uncomfortable sensation of breathing Pathophysiology of dyspnea Thorax
2 Perception Perception Central Drive Central Drive Cross-talk Pathophysiology Dyspnea How to measure dyspnea Functional dyspnea scale Modified Medical Research Council BDI-TDI SGRQ. CAT CRQ Exercise scale Borg VAS Functional dyspnea scale Medical Research Council 0 I only get breathless with strenuous exercise. 1 I get short of breath when hurrying on level ground or walking up a slight hill 2 On level ground, I walk slower than people of the same age because of breathlessness, or have to stop for breath when walking at my own pace. 3 I stop for breath after walking about 100 yards or after a few minutes on level ground 4 I am too breathless to leave the house or I am breathless when dressing
3 Multicenter in Japan n = 222 F/U for 5 years Outcome: Mortality Mortality: Dyspnea How to measure dyspnea Functional dyspnea scale Modified Medical Research Council BDI-TDI SGRQ. CAT CRQ Exercise scale Borg VAS Nishimura Chest 2002;121:1434 Exercise dyspnea No SOB Worst SOB ever O 2 Respiration CPET Air Ventilation Circulation Muscle Mitochondria CO 2
4 Exercise Test: Cardiac R L O 2 delivered = CO x O 2 content O 2 content = Hgb x 1.34 x % sat Low exercise capacity (VO 2 ) Decreased heart rate reserve (HR/Pred HR) Large ventilatory reserve (VE/MVV) Early AT ECG or BP changes No ABG changes Exercise Test: Respiratory Low exercise capacity (VO 2 ) Low breathing reserve (VE/MVV) Large heart reserve (HR/Pred HR) PaO 2 or O 2 sat may decrease PaCO 2 rises or fails to decrease AT not reached No ECG or BP change Example : COPD COPD: Patho-radiology Normal Disease Progression Static IC IRV V T ERV Air Trapping at Rest RV Years - Decades Rest
5 IC Normal IRV V T ERV RV Disease Progression Years - Decades Static Air Trapping at Rest Rest Dynamic Additional Air Trapping During Exercise Seconds - Minutes Exercise Pathophysiology Dyspnea Pharmacotherapy LVR Oxygen Central Drive Sedation Rehab Bronchodilator therapy, Therapy pulmonary and Health rehabilitation Status and health status Change in CRQ total score Threshold for clinical signficicance significance Mahler D et al. Chest 1999; 115: Placebo Salmeterol Ipratropium Pulm Rehab Griffiths TL, et al. Lancet 2000; 355: From ZuWallack Repeated P.R. courses over 7 years Rehabilitation Unbeatable Evidence A Observational study N = 48. FEV 1 = 58% 5 courses, OP Outcomes: FEV 1 SGRQ BDI/TDI BODE Change p value FEV 1 (ml) -18 (22) <0.001 SGRQ (u) -9.6 (14) < BODE (u) 0.71 (1.6) <0.001 Foglio et al Respir Med 2007;101:1961
6 LVRS in COPD Patho-bio-physiology R.Y. 58 years Emphysema FEV 1 = 38 % FRC = 192 % DLCO = 49 % MMRC = ¾ 6MWD = 198 m BODE = 7 Brantigan et al ARRD 1959 Patho-bio-physiology FEV 1 = 41 FRC = 172 % 6MWD = + 78 m MRC = - 2 DLCO = 49 % BODE = 5 Conclusions Dyspnea is a frequent symptom in the clinic The cause can be the lungs, heart, vascular, anemia, muscle or idiopathic Dyspnea can be measured and should be measured functionally or during stimulus A CPET may help determine origin should be directed at the cause References Graded comprehensive CPET in the evaluation of dyspnea unexplained by routine evaluation. Martinez FJ, Stanopoulos I, Acero R, Becker FS, Pickering R, Beamis JF. Chest. 1994;105: Measuring shortness of breath in heart failure (SOB-HF): development and validation of a new dyspnoea assessment tool. Ekman I, Granger B, Swedberg K, Stenlund H, Boman K. Eur J Heart Fail. 2011;13: American College of Chest Physicians consensus statement on the management of dyspnea in patients with advanced lung or heart disease. Mahler DA, Selecky PA, Harrod CG, Benditt JO, Carrieri- Kohlman V, Curtis JR, Manning HL, Mularski RA, Varkey B, Campbell M, Carter ER, Chiong JR, Ely EW, Hansen-Flaschen J, O'Donnell DE, Waller A. Chest. 2010;137:
Pulmonary rehabilitation (PR) is an important
Power of Outcome Measurements to Detect Clinically Significant Changes in Pulmonary Rehabilitation of Patients With COPD* Juan Pablo de Torres, MD; Victor Pinto-Plata, MD; Edward Ingenito, MD; Peter Bagley,
More informationDisclosure and Conflict of Interest 8/15/2017. Pharmacist Objectives. At the conclusion of this program, the pharmacist will be able to:
Digging for GOLD Rebecca Young, PharmD, BCACP, Roosevelt University College of Pharmacy Assistant Professor of Clinical Sciences Practice Site Advocate Medical Group-Nesset Pavilion Disclosure and Conflict
More informationGuideline for the Diagnosis and Management of COPD
Guideline for the Diagnosis and Management of COPD Introduction Chronic obstructive pulmonary disease (COPD) is a respiratory disorder largely caused by smoking. It is characterized by progressive, partially
More informationChanging Landscapes in COPD New Zealand Respiratory Conference
Changing Landscapes in COPD New Zealand Respiratory Conference Dr Robert Young BMedSc MBChB DPhil (Oxon) FRACP FRCP Associate Professor Consultant Physician Changing Landscapes in COPD: Summary 1. Overview
More informationChronic Obstructive Pulmonary Disease Guidelines and updates
Chronic Obstructive Pulmonary Disease Guidelines and updates October 20, 2018 Saratoga Springs, NY COPD (Chronic obstructive pulmonary disease) is a major cause of mortality and morbidity in the United
More informationObjectives. Advances in Managing COPD Patients
4:45 5:30pm Advances in Managing Patients SPEAKER Nicola Hanania, MD, FCCP, FRCP, FACP Presenter Disclosure Information The following relationships exist related to this presentation: Nicola Hanania, MD,
More informationCOPD GOLD Guidelines & Barnet inhaler choices. Dr Dean Creer, Respiratory Consultant, Royal Free London NHS Foundation Trust
COPD GOLD Guidelines & Barnet inhaler choices Dr Dean Creer, Respiratory Consultant, Royal Free London NHS Foundation Trust GOLD 2017 Report: Chapters 1. Definition and Overview 2. Diagnosis and Initial
More informationApproach to CPET. CPET Cases. Case 1 4/4/2018. Impaired? Cardiac factors? Ventilatory factors?
Approach to CPET CPET Cases Neil MacIntyre MD Duke University Medical Center Durham NC Impaired? Work,, /kg Cardiac factors?, /, BP, Rhythm Ventilatory factors? Ve/MVV (incl EIB, trapping), PaCO2 Gas exchange
More informationClinical pulmonary physiology. How to report lung function tests
Clinical pulmonary physiology or How to report lung function tests Lung function testing A brief history Why measure? What can you measure? Interpretation/ reporting Examples and case histories Exercise
More informationTSANZ/ANZSRS meeting 31 Mar Clinical utility of CPET. Bhajan Singh MBBS FRACP PhD
TSANZ/ANZSRS meeting 31 Mar 2015 Clinical utility of CPET Bhajan Singh MBBS FRACP PhD Head of Department, Pulmonary Physiology & Sleep Medicine, Sir Charles Gairdner Hospital Director, West Australian
More informationUsefulness of the Medical Research Council (MRC) dyspnoea scale as a measure of disability in patients with chronic obstructive pulmonary disease
Thorax 1999;54:581 586 581 Academic Department of Respiratory Medicine, St Bartholomew s and Royal London School of Medicine and Dentistry, London Chest Hospital, London, UK EAPaul R Garrod R Garnham J
More informationPFT Interpretation and Reference Values
PFT Interpretation and Reference Values September 21, 2018 Eric Wong Objectives Understand the components of PFT Interpretation of PFT Clinical Patterns How to choose Reference Values 3 Components Spirometry
More informationReducing lung volume in emphysema Surgical Aspects
Reducing lung volume in emphysema Surgical Aspects Simon Jordan Consultant Thoracic Surgeon Royal Brompton Hospital Thirteenth Cambridge Chest Meeting April 2015 Surgical aspects of LVR Why we should NOT
More informationCOPD. Salah Zeineldine, MD FACP Pulmonary & Critical Care Medicine American University of Beirut Lebanese Society of Family Medicine 2012
COPD Salah Zeineldine, MD FACP Pulmonary & Critical Care Medicine American University of Beirut Lebanese Society of Family Medicine 2012 Attitude It is a disease on which a good deal of wholly, unmerited
More informationCOPD: A Renewed Focus. Disclosures
COPD: A Renewed Focus Heath Latham, MD Assistant Professor Division of Pulmonary and Critical Care Medicine Disclosures No Business Interests No Consulting No Speakers Bureau No Off Label Use to Discuss
More informationNews on Evidence-Based Care Fourth Quarter 2013 Volume 5 Issue 4
SPECIAL EDITION: COPD CME AVAILABLE! News on Evidence-Based Care Fourth Quarter 2013 Volume 5 Issue 4 Update on Chronic Obstructive Lung Disease (COPD) 2013 During 2013, the Institute for Evidence-Based
More informationJOINT CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) MANAGEMENT GUIDELINES
JOINT CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) MANAGEMENT GUIDELINES Authors Dr Ian Benton Respiratory Consultant COCH Penny Rideal Respiratory Nurse COCH Kirti Burgul Respiratory Pharmacist COCH Pam
More informationCardiac & Pulmonary Rehab Individual Treatment Plan
Initial Assessment Date: Re-Assessment Date: Re-Assessment Date: Follow-Up Discharge Date: Risk Assessment Risk Assessment Risk Assessment Risk Assessment BP SpO2 BP SpO2 BP SpO2 BP SpO2 HR Edema HR Edema
More informationPatient Reported Outcomes
Patient Reported Outcomes INTRODUCTION TO CLINICAL RESEARCH A TWO-WEEK INTENSIVE COURSE, 2010 Milo Puhan, MD, PhD, Associate Professor Key messages Patient-reported outcomes (PRO) is a broad group of outcomes
More informationIs there any evidence that multi disciplinary pulmonary rehabilitation impacts on quality of life?
Is there any evidence that multi disciplinary pulmonary rehabilitation impacts on quality of life? Summary of the evidence located: According to the NICE guideline on Chronic Obstructive Pulmonary Disease
More informationFarmaci inalatori e dispnea nell asma e nella BPCO. Federico Lavorini
Farmaci inalatori e dispnea nell asma e nella BPCO Federico Lavorini Dept. Experimental and Clinical Medicine Careggi University Hospital Florence - Italy Presenter Disclosures F.L. has received in the
More informationIntegrating a Plan of Action for Life
Reference Guide for Individual Patient Education Educational topics: Integrating a Plan of Action for Life 1. Prevention and management of COPD exacerbations Reasons for using an Action Plan and its structure
More informationVA/DoD Clinical Practice Guideline Management of COPD Pocket Guide
VA/DoD Clinical Practice Guideline Management of COPD Pocket Guide MODULE A: MAAGEMET OF COPD 1 2 Patient with suspected or confirmed COPD presents to primary care [ A ] See sidebar A Perform brief clinical
More informationManaging COPD --- New Standard of Care
Managing COPD --- New Standard of Care Introduction Pathophysiology Recent advance in treatment Pharmacology Pulmonary rehabilitation Surgical treat Facts About COPD COPD is the 4 th leading cause of death
More informationObjective: Prepare NBRC candidate for CRT and WRT Content Outline
STRESS TEST AND HEMODYNAMICS Lois Rowland, MS, RRT-NPS, RPFT, FAARC Objective: Prepare NBRC candidate for CRT and WRT Content Outline Perform, evaluate patient response to, interpret results from: Stress
More informationChapter 21. Flail Chest. Mosby items and derived items 2011, 2006 by Mosby, Inc., an affiliate of Elsevier Inc.
Chapter 21 Flail Chest 1 Figure 21-1. Flail chest. Double fractures of three or more adjacent ribs produce instability of the chest wall and paradoxical motion of the thorax. Inset, Atelectasis, a common
More informationCOPD/ Asthma. Dr Heather Lewis Honorary Clinical Lecturer
COPD/ Asthma Dr Heather Lewis Honorary Clinical Lecturer Objectives To understand the pathogenesis of asthma/ COPD To recognise the clinical features of asthma/ COPD To know how to diagnose asthma/ COPD
More informationCOPD is a progressive disorder leading to increasing
Improvement in Exercise Tolerance With the Combination of Tiotropium and Pulmonary Rehabilitation in Patients With COPD* Richard Casaburi, MD, PhD, FCCP; David Kukafka, MD, FCCP; Christopher B. Cooper,
More informationExercise in the management of breathlessness
WHO Collaborating Centre for Palliative Care and Older People Exercise in the management of breathlessness Matthew Maddocks PhD Lecturer in Health Services Research NIHR Clinical Trials Fellow Maddocks
More informationPulmonary Rehabilitation in Chronic Lung Disease; Components and Organization. Prof. Dr. Müzeyyen Erk Cerrahpaşa Medical Faculty Chest Disease Dept.
Pulmonary Rehabilitation in Chronic Lung Disease; Components and Organization Prof. Dr. Müzeyyen Erk Cerrahpaşa Medical Faculty Chest Disease Dept. Plan Chronic Respiratory Disease Definition Factors Contributing
More informationBode index as a predictor of severity in patients with chronic obstructive pulmonary disease.
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-issn: 2279-0853, p-issn: 2279-0861.Volume 15, Issue 5 Ver. VII (May. 2016), PP 93-100 www.iosrjournals.org Bode index as a predictor of severity
More informationPreoperative assessment for lung resection. RA Dyer
Preoperative assessment for lung resection RA Dyer 2016 The ideal assessment of operative risk would identify every patient who could safely tolerate surgery. This ideal is probably unattainable... Mittman,
More informationWirral COPD Prescribing Guidelines
Wirral COPD Prescribing Guidelines (To be read in conjunction with the Wirral COPD Supplementary Information) STEP 1: Assess symptoms COPD Assessment Test (CAT) [Link for CAT-test Online] is a patient-completed
More informationImpacting patient-centred outcomes in COPD: breathlessness and exercise tolerance
Eur Respir Rev 2006; 15: 99, 37 41 DOI: 10.1183/09059180.00009903 CopyrightßERSJ Ltd 2006 Impacting patient-centred outcomes in COPD: breathlessness and exercise tolerance D.E. O Donnell ABSTRACT: The
More information호흡재활치료 울산의대서울아산병원 호흡기내과 이상도
호흡재활치료 울산의대서울아산병원 호흡기내과 이상도 Systemic (Extrapulmonary) effects in COPD Skeletal muscle dysfunction Osteoporosis Weight loss Sexual dysfunction Cardiovascular diseases (Gross et al., Curr Opin Pulm Med 2001;7:84)
More informationLung Volume Reduction Surgery. February 2013
Lung Volume Reduction Surgery February 2013 Presentation Outline Lung Volume Reduction Surgery (LVRS) Rationale & Historical Perspective NETT Results Current LVRS Process (from referral to surgery) Diagnostic
More informationAlgorithm for the use of inhaled therapies in COPD Version 2 May 2017
Algorithm for the use of inhaled therapies in COPD This document has been revised by the Berkshire West Respiratory Network to support clinicians in selecting the most appropriate, cost effective treatments
More informationThe addition of non-invasive ventilation during exercise training in COPD patients. Enrico Clini and Michelle Chatwin
Thank you for viewing this presentation. We would like to remind you that this material is the property of the author. It is provided to you by the ERS for your personal use only, as submitted by the author.
More informationIdiopathic pulmonary fibrosis (IPF) is the. A simple assessment of dyspnoea as a prognostic indicator in idiopathic pulmonary fibrosis
Eur Respir J 2010; 36: 1067 1072 DOI: 10.1183/09031936.00152609 CopyrightßERS 2010 A simple assessment of dyspnoea as a prognostic indicator in idiopathic pulmonary fibrosis O. Nishiyama*,", H. Taniguchi*,
More informationAECOPD: Management and Prevention
Neil MacIntyre MD Duke University Medical Center Durham NC Professor P.J. Barnes, MD, National Heart and Lung Institute, London UK Professor Peter J. Barnes, MD National Heart and Lung Institute, London
More informationChronic Obstructive Pulmonary Disease (COPD).
Chronic Obstructive Pulmonary Disease (COPD). Linde: Living healthcare 02 03 Chronic Obstructive Pulmonary Disease (COPD). A pocket guide for healthcare professionals. COPD the facts Moderate to severe
More informationComparisons of health status scores with MRC grades in COPD: implications for the GOLD 2011 classification
ORIGINAL ARTICLE COPD Comparisons of health status scores with MRC grades in COPD: implications for the GOLD 2011 classification Paul W. Jones 1, Lukasz Adamek 2, Gilbert Nadeau 2 and Norbert Banik 3 Affiliations:
More informationDoes the multidimensional grading system (BODE) correspond to differences in health status of patients with COPD?
AUTHOR COPY ORIGINAL RESEARCH Does the multidimensional grading system (BODE) correspond to differences in health status of patients with COPD? Kian-Chung Ong 1 Suat-Jin Lu 1 Cindy Seok-Chin Soh 2 1 Department
More informationBasic approach to PFT interpretation. Dr. Giulio Dominelli BSc, MD, FRCPC Kelowna Respiratory and Allergy Clinic
Basic approach to PFT interpretation Dr. Giulio Dominelli BSc, MD, FRCPC Kelowna Respiratory and Allergy Clinic Disclosures Received honorarium from Astra Zeneca for education presentations Tasked Asked
More informationCardiopulmonary Exercise Testing Cases
Canadian Respiratory Conference - 217 Cardiopulmonary Exercise Testing Cases Darcy D Marciniuk, MD FRCPC FCCP Associate Vice-President Research, University of Saskatchewan Professor, Respirology, Critical
More informationThey Can t Bury You while You re Still Moving: Update on Pulmonary Rehabilitation
They Can t Bury You while You re Still Moving: Update on Pulmonary Rehabilitation Richard ZuWallack, MD Associate Chief, Pulmonary and Critical Care St. Francis Hospital, Hartford, CT Professor of Medicine
More informationEffectiveness of Acu-TENS on Reducing Dyspnoea and Improving Physical Ability on Stable COPD patients A Controlled Trial
Effectiveness of Acu-TENS on Reducing Dyspnoea and Improving Physical Ability on Stable COPD patients A Controlled Trial Author: Ms. Ching Hiu Wai, Amanda Physiotherapist I, Tuen Mun Hospital (TMH) Collaborators:
More informationPulmonary Rehabilitation
Pulmonary Rehabilitation What do these patients have in common? Factors contributing to exercise intolerance Factors contributing to exercise intolerance Factors contributing to exercise intolerance Factors
More informationThe distribution of COPD in UK general practice using the new GOLD classification
ORIGINAL ARTICLE COPD The distribution of COPD in UK general practice using the new GOLD classification John Haughney 1, Kevin Gruffydd-Jones 2, June Roberts 3, Amanda J. Lee 4, Alison Hardwell 5 and Lorcan
More informationThree s Company - The role of triple therapy in chronic obstructive pulmonary
Three s Company - The role of triple therapy in chronic obstructive pulmonary disease (COPD) October 26 th, 2018 Zahava Picado, PharmD PGY1 Pharmacy Resident Central Texas Veterans Healthcare System Zahava.Picado@va.gov
More informationMinimal important difference of the transition dyspnoea index in a multinational clinical trial
Eur Respir J 2003; 21: 267 272 DOI: 10.1183/09031936.03.00068503a Printed in UK all rights reserved Copyright #ERS Journals Ltd 2003 European Respiratory Journal ISSN 0903-1936 Minimal important difference
More informationCOPD is a syndrome of chronic limitation in expiratory airflow encompassing emphysema or chronic bronchitis.
1 Definition of COPD: COPD is a syndrome of chronic limitation in expiratory airflow encompassing emphysema or chronic bronchitis. Airflow obstruction may be accompanied by airway hyper-responsiveness
More informationDecramer 2014 a &b [21]
Buhl 2015 [19] Celli 2014 [20] Decramer 2014 a &b [21] D Urzo 2014 [22] Maleki-Yazdi 2014 [23] Inclusion criteria: Diagnosis of chronic obstructive pulmonary disease; 40 years of age or older; Relatively
More informationEffects of controlled inspiratory muscle training in patients with COPD: a metaanalysis.
Eur Respir J 22; 2: 57 576 DOI: 1.1183/931936.2.23742 Printed in UK all rights reserved Copyright #ERS Journals Ltd 22 European Respiratory Journal ISSN 93-1936 Effects of controlled inspiratory muscle
More informationCARE OF THE ADULT COPD PATIENT
CARE OF THE ADULT COPD PATIENT Target Audience: The target audience for this clinical guideline is all MultiCare providers and staff including those associated with our Clinically Integrated Network. The
More informationThe physiological hallmark of chronic. Tiotropium as essential maintenance therapy in COPD. M. Decramer
Eur Respir Rev 2006; 15: 99, 51 57 DOI: 10.1183/09059180.00009906 CopyrightßERSJ Ltd 2006 Tiotropium as essential maintenance therapy in COPD M. Decramer ABSTRACT: Over the past decade, several large-scale
More informationThe Modified BODE Index: Validation with Mortality in COPD
ERJ Express. Published on June 25, 2008 as doi: 10.1183/09031936.00138507 The Modified BODE Index: Validation with Mortality in COPD Claudia G. Cote, M.D 1, Victor Pinto-Plata 2, M.D, Jose M. Marin, M.D
More informationARTICLE IN PRESS. Katia Foglio a, Luca Bianchi a, Gisella Bruletti b, Roberto Porta a, Michele Vitacca a, Bruno Balbi c, Nicolino Ambrosino d,
Respiratory Medicine (07) 101, 1961 1970 Seven-year time course of lung function, symptoms, health-related quality of life, and exercise tolerance in COPD patients undergoing pulmonary rehabilitation programs
More informationIn patients with symptomatic COPD, desirable. Assessment of Bronchodilator Efficacy in Symptomatic COPD* Is Spirometry Useful?
Assessment of Bronchodilator Efficacy in Symptomatic COPD* Is Spirometry Useful? Denis E. O Donnell, MD, FCCP Bronchodilator therapy in COPD is deemed successful if it improves ventilatory mechanics to
More informationCHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) MOUSTAPHA ABIDALI, DO CRITICAL CARE FELLOW UNIVERSITY OF ARIZONA- PHOENIX
CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) MOUSTAPHA ABIDALI, DO CRITICAL CARE FELLOW UNIVERSITY OF ARIZONA- PHOENIX COPD OUTLINE Definition and Overview Pathophysiology Diagnosis and Assessment Therapeutic
More informationIndacaterol on dyspnea in chronic obstructive pulmonary disease: a systematic review and meta-analysis of randomized placebo-controlled trials
Han et al. BMC Pulmonary Medicine 2013, 13:26 RESEARCH ARTICLE Open Access on dyspnea in chronic obstructive pulmonary disease: a systematic review and meta-analysis of randomized placebo-controlled trials
More informationOxygen and ABG. Dr Will Dooley
Oxygen and ABG G Dr Will Dooley Oxygen and ABGs Simply in 10 cases Recap of: ABG interpretation Oxygen management Some common concerns A-a gradient Base Excess Anion Gap COPD patients CPAP/BiPAP First
More informationWhat s new in COPD? Apichart Khanichap MD. Department of Medicine, Faculty of Medicine, Thammasat university
What s new in COPD? Apichart Khanichap MD. Department of Medicine, Faculty of Medicine, Thammasat university Management stable COPD Relieve symptoms Improve exercise tolerance Improve health status Prevent
More informationDefining COPD. Georgina Grantham Community Respiratory Team Leader/ Respiratory Nurse Specialist
Defining COPD Georgina Grantham Community Respiratory Team Leader/ Respiratory Nurse Specialist Defining COPD Chronic Obstructive Pulmonary Disease (COPD) is a common, preventable and treatable disease
More informationUPDATE ON GOLD GUIDELINES IN COPD
UPDATE ON GOLD GUIDELINES IN COPD GERARD J. CRINER, MD, FACP, FACCP PROFESSOR, THORACIC MEDICINE & SURGERY TEMPLE UNIVERSITY SCHOOL OF MEDICINE PHILADELPHIA, PA Gerard J. Criner, MD, is Professor and Founding
More informationAlgorithm for the use of inhaled therapies in COPD
Berkshire West Integrated Care System Representing Berkshire West Clinical Commisioning Group Royal Berkshire NHS Foundation Trust Berkshire Healthcare NHS Foundation Trust Berkshire West Primary Care
More informationGOLD UPDATE on COPD and the Importance of Accurate Dyspnea Evaluation
GOLD UPDATE on COPD and the Importance of Accurate Dyspnea Evaluation George Anderson, PhD Sr. Medical Science Liaison MA-AZAP ML-4006-US-0212 Approved 11/16 Glob al Strategy for the Diagnosis, Management,
More informationMeasuring Exertional Dyspnoea in Health and Disease
Measuring Exertional Dyspnoea in Health and Disease AIMS Prof. Denis O'Donnell Respiratory Investigation Unit Kingston General Hospital & Queen s University Kingston Richardson House 102 Stuart Street
More informationStudy No.: Title: Rationale: Phase: Study Period Study Design: Centres: Indication: Treatment: Objectives : Primary Outcome/Efficacy Variable:
The study listed may include approved and non-approved uses, formulations or treatment regimens. The results reported in any single study may not reflect the overall results obtained on studies of a product.
More informationThe Art and Science of Pulmonary Rehab. Pam Haines, RCP Cardiopulmonary Rehab Manager
The Art and Science of Pulmonary Rehab Pam Haines, RCP Cardiopulmonary Rehab Manager ATS/ERS Statement on PR As defined by the 2013 ATS/ERS Statement on Pulmonary Rehabilitation, PR is a comprehensive
More informationChronic Obstructive Pulmonary Disease (COPD) KAREN ALLEN MD PULMONARY & CRITICAL CARE MEDICINE VA HOSPITAL OKC / OUHSC
Chronic Obstructive Pulmonary Disease (COPD) KAREN ALLEN MD PULMONARY & CRITICAL CARE MEDICINE VA HOSPITAL OKC / OUHSC I have no financial disclosures Definition COPD is a preventable and treatable disease
More informationOPTIMIZING MANAGEMENT OF COPD IN THE PRACTICE SETTING 10/16/2018 DISCLOSURES I have no financial or other disclosures
OPTIMIZING MANAGEMENT OF COPD IN THE PRACTICE SETTING J. Michael Fuller, MD, MEd, FACP, FCCP Associate Professor of Medicine University of South Carolina Greenville DISCLOSURES I have no financial or other
More informationCOPD, Asthma, Or Something In Between? Sharon R. Rosenberg Assistant Professor of Medicine Northwestern University December 4, 2013
COPD, Asthma, Or Something In Between? Sharon R. Rosenberg Assistant Professor of Medicine Northwestern University December 4, 2013 None Disclosures Definitions Asthma Asthma is a chronic inflammatory
More informationSelf-Management Plan for COPD
Self-Management Plan for COPD This is your personal management plan. The aim of this plan is to help you have better control of your chronic obstructive pulmonary disease (COPD). It will enable you to
More informationEvaluation of Respiratory Impairment Written by: Paul M. Deutsch, Ph.D., CRC, CCM, CLCP, FIALCP
Evaluation of Respiratory Impairment Written by: Paul M. Deutsch, Ph.D., CRC, CCM, CLCP, FIALCP The American Medical Association in its Guides to the Evaluation of Permanent Impairment recognizes four
More informationModern Management of COPD.
Modern Management of COPD. Associate Professor Robert Young BMedSc, MBChB, DPhil (Oxon), FRACP, FRCP Department of Medicine, Auckland City Hospital and University of Auckland, New Zealand 2 Sponsor Disclaimer
More informationRoflumilast (Daxas) for chronic obstructive pulmonary disease
Roflumilast (Daxas) for chronic obstructive pulmonary disease August 2009 This technology summary is based on information available at the time of research and a limited literature search. It is not intended
More informationRespiratory Medicine. Some pet peeves and other random topics. Kyle Perrin
Respiratory Medicine Some pet peeves and other random topics Kyle Perrin Overview 1. Acute asthma Severity assessment and management 2. Acute COPD NIV and other management 3. Respiratory problems in the
More informationFOLLOW-UP MEDICAL CARE OF SERVICE MEMBERS AND VETERANS CARDIOPULMONARY EXERCISE TESTING
Cardiopulmonary Exercise Testing Chapter 13 FOLLOW-UP MEDICAL CARE OF SERVICE MEMBERS AND VETERANS CARDIOPULMONARY EXERCISE TESTING WILLIAM ESCHENBACHER, MD* INTRODUCTION AEROBIC METABOLISM ANAEROBIC METABOLISM
More informationWhat do pulmonary function tests tell you?
Pulmonary Function Testing Michael Wert, MD Assistant Professor Clinical Department of Internal Medicine Division of Pulmonary, Critical Care, and Sleep Medicine The Ohio State University Wexner Medical
More informationDr Rob Young. General Physician Auckland City Hospital
Dr Rob Young General Physician Auckland City Hospital Managing COPD case studies. Associate Professor Robert Young BMedSc, MBChB, DPhil (Oxon), FRACP, FRCP Department of Medicine, Auckland City Hospital
More informationSelf-Management Plan for COPD
Self-Management Plan for COPD This is your personal management plan. The aim of this plan is to help you have better control of your chronic obstructive pulmonary disease (COPD). It will enable you to
More informationCOPD/Asthma. Prudence Twigg, AGNP
COPD/Asthma Prudence Twigg, AGNP COPD/Asthma Qualifying Diagnosis Known diagnosis of COPD/asthma or CXR showing COPD with hyperinflated lungs and no infiltrates + two or more: Wheezing, SOB, increased
More informationPatient reported outcomes in respiratory diseases; How to assess clinical success in COPD
Patient reported outcomes in respiratory diseases; How to assess clinical success in COPD Thys van der Molen, University of Groningen, Department of General Practice, The Netherlands Mr Valette Smoking
More informationClinical exercise testing
Basic principles of clinical exercise testing Clinical exercise testing This article is adapted from the on Basic principles of clinical exercise testing organised in Rome, March 2 4, 2006. Original slides,
More informationHome-based exercise is capable of preserving hospital-based improvements in severe chronic obstructive pulmonary disease*
RESPIRATORY MEDICINE (2000) 94, 1184 1191 doi:10.1053/rmed.2000.0949, available online at http://www.idealibrary.com on Home-based exercise is capable of preserving hospital-based improvements in severe
More informationexacerbation has greater impact on functional status than frequency of exacerbation episodes.
Original Article Singapore Med J 2011, 52(12) 894 Changes in the BODE index, exacerbation duration and hospitalisation in a cohort of COPD patients Bu X N, Yang T, Thompson M A, Hutchinson A F, Irving
More informationTesting Clinical Implications
Cardiopulmonary Exercise Testing Clinical Implications Dr Sahajal Dhooria Outline Basic concepts Case studies Recent advances in clinical applications of CPET Basic Concepts Exercise Any physical activity
More informationUpdate on heterogeneity of COPD, evaluation of COPD severity and exacerbation
Update on heterogeneity of COPD, evaluation of COPD severity and exacerbation Yung-Yang Liu, MD Taipei Veterans General Hospital Aug 29, 2015 G O lobal Initiative for Chronic bstructive L D ung isease
More information2/13/2018 OBESITY HYPOVENTILATION SYNDROME
OBESITY HYPOVENTILATION SYNDROME David Claman, MD UCSF Professor of Medicine Director, UCSF Sleep Disorders Center Disclosures: None. 1 COMPLICATIONS OF OSA Cardiovascular HTN, CHF, CVA, arrhythmia, Pulm
More informationPulmonary rehabilitation in severe COPD.
Pulmonary rehabilitation in severe COPD daniel.langer@faber.kuleuven.be Content Rehabilitation (how) does it work? How to train the ventilatory limited patient? Chronic Obstructive Pulmonary Disease NHLBI/WHO
More informationReferring for specialist respiratory input. Dr Melissa Heightman Consultant respiratory physician, UCLH,WH, CNWL
Referring for specialist respiratory input Dr Melissa Heightman Consultant respiratory physician, UCLH,WH, CNWL Respiratory Specialist- who? GPSI Community Team Secondary Care Respiratory physician and
More informationTHE COPD PRESCRIBING TOOL
THE COPD PRESCRIBING TOOL Revised edition, 2017 www.bpac.org.nz/copd CLASSIFICATION The COPD prescribing tool This tool provides pharmacological treatment options for patients with COPD based on their
More informationImages have been removed from the PowerPoint slides in this handout due to copyright restrictions.
Arterial Blood Gas Interpretation Routine Assessment Inspection Palpation Auscultation Labs Na 135-145 K 3.5-5.3 Chloride 95-105 CO2 22-31 BUN 10-26 Creat.5-1.2 Glu 80-120 Arterial Blood Gases WBC 5-10K
More information9/22/2015 CONFLICT OF INTEREST OBJECTIVES. Understanding COPD - Recent Research and the Evolving Definition of COPD for MNACVPR
Understanding COPD - Recent Research and the Evolving Definition of COPD for MNACVPR by Scott Cerreta, BS, RRT Director of Education www.copdfoundation.org scerreta@copdfoundation.org CONFLICT OF INTEREST
More informationUnderstanding COPD - Recent Research and the Evolving Definition of COPD for MNACVPR
Understanding COPD - Recent Research and the Evolving Definition of COPD for MNACVPR by Scott Cerreta, BS, RRT Director of Education www.copdfoundation.org scerreta@copdfoundation.org CONFLICT OF INTEREST
More informationCOPD A New Look at an Old Disease
A New Look at an Old Disease Disclosures Research support to institution from Roche/Genentech, GSK, Astra Zeneca, Cheisi, Sunovion, Mylan, Boehringer Ingelheim Research support from the American Lung Association
More informationNasal High Flow Humidification with or without Oxygen for COPD Management. Shereen Bailey, RCP, RRT, NPS
Nasal High Flow Humidification with or without Oxygen for COPD Management Shereen Bailey, RCP, RRT, NPS Objectives How it works COPD Management today The role of NHFC Evidence Research/Case Studies Types
More informationCardiopulmonary Exercise Testing: its principles, interpretation & application. DM Seminar Harshith
Cardiopulmonary Exercise Testing: its principles, interpretation & application DM Seminar Harshith Outline Physiology of exercise Introduction Equipment and working Principles Interpretation and variables
More information