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Transcript of COPD
COPD Management WHAT Symptoms Cough & Sputum Dyspnea on Exertion 勞力性呼吸困難 氣促 chronic productive cough is a hallmark of chronic bronchitis. It is due to excessive mucus production and airway wall thickening secondary to cigarette smoke. Affected subjects will have worsening of these symptoms after viral infection or deterioration of air quality Feeling breathless is a late symptom when the FEV 1 has fallen by more than 50% from its peak value. As lung function gradually deteriorates, patients become more and more breathless on exertion or with daily activities. Finally the unfortunate patient has difficulty in breathing even at rest. Burden There is a rising trend in the global incidence of COPD. The WHO estimated the disease will be the 5th commonest disease and the no. 3 killer in the world by 2020. Although the exact prevalence of the disease is not known in Hong Kong, a local study suggested 9% of the elderly above the age of 70 are its victim From statistics of the Hospital Authority, COPD was the cause of 4% of all urgent hospital admissions in 1997 and contributed 5.8% of all deaths in the same year. Causes Cigarette
smoking is related to 80-90% of all cases Non-smoking risk factors (10-20%) Occupational exposure to gold, coal, asbestos, cadmium, mineral dusts, fumes and gases.
Environmental exposure to wood smoke, sulphur dioxide, nitrogen dioxide.
Genetic factors including alpha1-antitrypsin deficiency.
Lung growth in utero, childhood viral infections. Chronic Bronchitis Emphysema Damage of air sacs Continuous inflammation of lining of breathing tubes DIAGNOSIS TREATMENT Severity stage STAKE HOLDERS ASSESSMENT Because of permanent lack of oxygen in blood due to COPD, very severe patients need external oxygen, which can be provided at home by Long-Term Oxygen Therapy
LTOT Long Term Oxygen Therapy Treatment Target Effect with LTOT GOLD guideline Pulmonary Rehabilitation Program (PRP) Principles of PRP Benefits of PRP Non-Pharmacologic Treatment
Pulmonary Rehabilitation programs should include, at a minimum:
Education Improve patients’ health conditions
Reduce the frequency of hospital re-admission or emergency department visits
Provide Total COPD management programs for both patients and healthcare professionals
TOOLS Stationary Oxygen Concentrator Oxygen Cylinder Portable Oxygen Concentrator Transportation Oxygen Concentrator Regulator Conserving Device Accessories Suction MDI and Spacer Lung Function Understanding of Flow Curve