Supervisors info:
Νικόλαος Κουλούρης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ, Επιβλέπων
Σπυρίδων Ζακυνθινός, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Ελένη Κορτιάνου, Αναπληρώτρια Καθηγήτρια, Τμήμα Φυσικοθεραπείας, ΤΕΙ Στερεάς Ελλάδας
Summary:
In pulmonary diseases a category with great effect on mortality in general population and on deterioration in quality of life is obstructive diseases and especially COPD (Chronic Obstructive Pulmonary Disease) and bronchial asthma.
COPD is estimated to be the 3rd main cause of death in 2020.
Reduced lung function (pulmonary artery stenosis, obstruction and airways inflammation), dynamic hyperinflation, respiratory muscle failure, presence of symptoms, decreased stamina in exercise and exacerbations are results of the disease.
A high rate of exacerbation is recorded every year in patients with COPD and bronchial asthma, which lead to increased use of health services and contribute to the poor clinical course and progress of the disease causing increased morbidity and mortality.
Exacerbation is defined as the persistent deterioration in the clinical condition of patients compared to their stable condition, showing an acute initiation, and demanding immediate treatment with special handling.
The common characteristics of exacerbation are catarrh, tachypnea, cough, sore throat, fever, sputum of increased volume and with change in color, putrid sputum and increased dyspnea.
It is distinguished in: a) mild, which is treated with short-acting bronchodilators, b) moderate, which is treated with antibiotics – corticoids and c) severe, the treatment of which demands hospitalization – visit to the emergency department – administration of medication and oxygen therapy – noninvasive ventilation and finally invasive ventilation.
For a better outcome of exacerbation and course of the disease it is important/vital to provide patient with holistic care with:
Α) prevention: stop smoking – medication, stable disease treatment – healthy lifestyle – vaccinations – training on chronic disease and exacerbations self-management – participation in programs for respiratory rehabilitation – utilization of telemedicine programs.
Β) early detection and treatment – early diagnosis, which result in less admissions and visits to emergency department (cost effectiveness) – reduced recovery time and improved quality of life.
C) personalization of treatment, with evaluation of parameters according to symptoms, exacerbation frequency and comorbidity.
D) follow-up (continuous) of disease course in cooperation with trained medical and nursing staff and health professionals under the guidelines in P.H.C. (Primary Healthcare).
Although we know that exacerbations are key events in chronic obstructive pulmonary disease (COPD), understanding the frequency, the determinants and their effects is incomplete. The role of pathogenic bacteria in acute exacerbations of chronic obstructive pulmonary disease is also controversial. The work will try to make a brief review of COPD, how it works, its causes, and the nursing and therapeutic methods to deal with it.
Keywords:
Treatment, Exacerbation, Obstructive, Diseases
