Description
Title: Chronic obstructive pulmonary disease in its final stages
Abstract: As many patients with chronic obstructive pulmonary disease (COPD) pass away every year as those with lung cancer, but the care of the most severe patients, those with Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages III and IV with chronic respiratory failure, is not well-recommended by current guidelines. Only long-term oxygen therapy (LTOT) and quitting smoking increase COPD patient survival. There is little evidence to support the routine management of stable hypercapnic COPD patients with non-invasive positive pressure ventilation (NPPV), despite the possibility that it may play an adjunctive role in the treatment of chronic respiratory insufficiency. Different prospective, randomised, controlled studies, systematic reviews, and meta-analyses provide strong support for the clinical efficacy of NPPV in treating acute and chronic respiratory failure brought on by acute COPD exacerbations. In addition, NPPV is an alternative to invasive ventilation for treating end-stage COPD symptoms. Only a small proportion of patients will likely benefit from surgical interventions for end-stage COPD like bullectomies, various modalities of lung volume reduction surgery, and lung transplantation. But there are certain signs that, when combined with pulmonary rehabilitation, will improve exercise capacity and quality of life. Similar to other chronic diseases, when a disease’s severity worsens over the course of its natural history, palliative therapy—which aims to relieve symptoms—becomes less and less significant. Bronchodilators are the most effective way to treat dyspnea, though opiates can also help. In hypoxemic COPD patients, additional oxygen improves exercise tolerance and reduces breathlessness during exertion. The elderly and frail COPD patients can be challenging to treat with antidepressants. By evaluating symptoms and offering patients and their families psychological and social support, good clinical care can either prevent or lessen suffering.
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Paper Quality: SCOPUS / Web of Science Level Research Paper
Subject: Advances in Respiratory Medicine
Writer Experience: 20+ Years
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