Treatment Management in Acute Exacerbation of COPD in the Emergency Department
Erdal Tekin
Mustafa Bayraktar
Department of Family Medicine, Faculty of Medicine, University of Ataturk
Tuğba Sanalp Menekşe
Atıf Bayramoğlu
Department of Emergency Medicine, Faculty of Medicine, University of Ataturk
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Keywords

COPD
Acute exacerbation
Nebulizer
Oxygen
Blood gas

How to Cite

Tekin, E., Bayraktar, M., Menekşe, T., & Bayramoğlu, A. (2020). Treatment Management in Acute Exacerbation of COPD in the Emergency Department. International Journal of Innovative Research and Reviews, 4(2), 23-39. Retrieved from http://www.injirr.com/article/view/64

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.

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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 Pac Fam Med (2015) 14(1):4.
[5] Riley CM, Sciurba FC. Diagnosis and Outpatient Management of Chronic Obstructive Pulmonary Disease: A Review. JAMA (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: 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. Eur Respir J (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. Med Clin North Am (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 (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. Eur Respir J (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. J Aerosol Med Pulm Drug Deliv (2014) 27(6):430–440.
[19] Cates CJ, Bestall J, Adams N. Holding chambers versus nebulisers for inhaled steroids in chronic asthma. Cochrane Database Syst Rev (2006)(1):Cd001491.
[20] Martin AR, Finlay WH. Nebulizers for drug delivery to the lungs. Expert Opin Drug Deliv (2015) 12(6):889–900.
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