• nishitaagarwal

Care for Patients with COPD



What is COPD?

COPD stands for Chronic obstructive pulmonary disease - it is a chronic inflammatory lung disease that causes obstructed airflow from the lungs. The symptoms include difficulty in breathing, cough, mucus (sputum) production and wheezing.


COPD is typically caused by long-term exposure to irritating gasses or particulate matter, in most cases is caused by cigarette smoke. Patients suffering with COPD are at increased risk of developing heart disease, lung cancer and a variety of other conditions.


Chronic obstructive pulmonary disease or COPD is the name given to a group of lung conditions that cause breathing difficulties. This includes :

Emphysema – damage to the air sacs in the lungs

Chronic Bronchitis – long-term inflammation of the airways


COPD or Chronic obstructive pulmonary disease is a condition that mainly affects middle-aged or older adults who smoke. Many people may experience - COPD without realising they have it.


The breathing problems due to COPD - tend to get gradually worse over time and can limit your normal activities. Proper treatment can help keep the condition under control.



Symptoms of COPD

The symptoms for COPD often don't appear until significant lung damage has been done - these symptoms normally tend to worsen over time, particularly if smoking exposure continues. Signs and symptoms of COPD may include:

  • Shortness of breath, especially during physical activities

  • Wheezing

  • Chest tightness

  • A chronic cough that may produce mucus (sputum) that may be clear, white, yellow or greenish

  • Frequent respiratory infections

  • Lack of energy

  • Unintended weight loss (in later stages)

  • Swelling in ankles, feet or legs



Risk Factors for COPD:

Smoking is the biggest risk factor for COPD. Approximately 85 to 90 percent of COPD cases are caused by smoking. Other risk factors that can cause COPD may include:

  • A history of childhood respiratory infection

  • Breathing secondhand smoke

  • Working with chemicals, dust and fumes or exposure to air pollution

  • A genetic condition called Alpha-1 deficiency



Treatment for COPD:

The damage to the lungs caused by COPD is permanent, but treatment can help slow down the progression of the condition.


Treatments include:


Quit smoking

The most essential step in any treatment plan for COPD is to quit all smoking. Stopping smoking can keep COPD from getting worse and reducing your ability to breathe.

Medications

Several kinds of medications are used to treat the symptoms and complications of COPD.

  • Lung therapies:

  1. Oxygen therapy. If there isn't enough oxygen in your blood, you may need supplemental oxygen. There are several devices that deliver oxygen to your lungs, including lightweight, portable units that you can take with you to run errands and get around town.

  2. Pulmonary rehabilitation program. These programs generally combine education, exercise training, nutrition advice and counseling. You'll work with a variety of specialists, who can tailor your rehabilitation program to meet your needs.


In-home noninvasive ventilation therapy

A noninvasive ventilation therapy machine - like BiPAP & CPAP with a mask helps to improve breathing and decrease retention of carbon dioxide (hypercapnia)

Managing exacerbations

Even with ongoing treatment, you may experience times when symptoms become worse for days or weeks. This is called an acute exacerbation, and it may lead to lung failure if you don't receive prompt treatment. When exacerbations occur, you may need additional medications (such as antibiotics, steroids or both), supplemental oxygen or treatment in the hospital.



Medical Equipments for COPD:


Oxygen Concentrator

Let's take a look at the working of an oxygen concentrator. It draws in air from the room around it, purifies it, compresses it, stores it in a tank, then delivers the fresh air via cannula to your lungs. These days, amaller, more compact portable oxygen concentrators are also available these can be travelled with easily. They work off rechargeable batteries while you’re away from an outlet. Some deliver O2 continuously, but most give it through pulsed doses, or bursts each time you inhale. Why get an oxygen concentrator over an oxygen cylinder? An oxygen concentrator need not be refilled periodically, can be used for longer hours. But if in your city - electricity goes often - you must have an oxygen cylinder as a backup unit.


CPAP, BiPAP

CPAP (continuous positive airway pressure) and BiPAP (bi-level positive airway pressure) machines use pressure to open airways for better breathing. In both, a mask is applied over the face, and pressures are supplied to make sure that the air reaches luns properly.

So, what's the difference between CPAP and BiPAP? Well, the key difference is that CPAP delivers only a single level of preset air pressure. The same continuous pressure is delivered during both inhalation and exhalation. This can make exhaling more difficult for people - who are not able to exhale on their own. BiPAP machines whereas provide two different levels of air pressure, which makes breathing out easier than it is with a CPAP machine.


BiPAP is preferred equipment for people with COPD. It lessens the work it takes to breathe, which is important in people with COPD who expend a lot of energy breathing and is helpful for COPD patients whose blood tests during an exacerbation show high levels of carbon dioxide.


Oxygen Cylinder

Another way of taking supplemental oxygen, is oxygen cylinder. An oxygen cylinder is one of the most common at home oxygen device. These oxygen cylinders come in various sizes, depending on the amount of oxygen you need, as prescribed by your doctor. Your doctor will suggest you the pressure based on your oxygen levels. So why, get an oxygen cylinder over an oxygen concentrator? The biggest pro is the point that a cylinder can work without electricity and can provide a greater pressure - needed for critical patients.

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