COPD Connect
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3yr
High inhaler resistance does not limit successful inspiratory maneuver among patients with asthma or COPD - PubMed

High inhaler resistance does not limit successful inspiratory maneuver among patients with asthma or COPD - PubMed

Source : https://pubmed.ncbi.nlm.nih.gov/36820500/

The evidence supports the efficacy of DPIs irrespective of respiratory condition or age of the patient even during acute exacerbations. Air flow resistance does not limit the use of DPIs...



Expert Opinion: The evidence supports the efficacy of DPIs irrespective of respiratory condition or age of the patient even during acute exacerbations. Air flow resistance does not limit the use of DPIs and the patients were able to generate sufficient inspiratory flow rate with almost any device studied. None of 16 identified clinical trials...

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3yr
The effect of exhalation before the inhalation of dry powder aerosol drugs on the breathing parameters, emitted doses and aerosol size distributions

The effect of exhalation before the inhalation of dry powder aerosol drugs on the breathing parameters, emitted doses and aerosol size distributions

Source : https://www.sciencedirect.com/science/article/pii/S2590156723000117?via=ihub

Airway deposition of aerosol drugs is highly dependent on the breathing manoeuvre of the patients. Though incorrect exhalation before the inhalation of the drug is one of the most common...



Conclusions/Relevance: All these effects and parameter values point toward higher airway doses due to forceful exhalation before the inhalation of the drug. At the same time, the present findings highlight the necessity of proper patient education on the importance of lung emptying, but also the importance of patient-specific inhaler-drug...

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3yr
A Prediction Scoring Model for the Effect of Withdrawal or Addition of Inhaled Corticosteroids in Patients with Chronic Obstructive Pulmonary Disease

A Prediction Scoring Model for the Effect of Withdrawal or Addition of Inhaled Corticosteroids in Patients with Chronic Obstructive Pulmonary Disease

Source : https://www.dovepress.com/a-prediction-scoring-model-for-the-effect-of-withdrawal-or-addition-of-peer-reviewed-fulltext-article-COPD

Chronic obstructive pulmonary disease (COPD) is among the most common causes of death in the world. The mainstay of treatment for COPD is inhaled bronchodilator therapy. Conversely, the role of...



Conclusion: The presented CASPER model might be able to predict and compare the risk of composite events when dual bronchodilator or triple therapy is administered to COPD patients.

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3yr
The importance of treating COPD early

Early COPD can refer to the destruction/loss of the terminal/transitional bronchioles that arises before a deterioration in lung function is demonstrated. It can manifest in the absence of emphysematous destruction, with surviving airways exhibiting narrowed lumens/thickened walls. Defining “early COPD” can be challenging, with the 2023 Global Initiative for Obstructive Lung Disease (GOLD) guidelines preferring a “biologic” to “clinical” definition.



According to the 2023 Global GOLD guidelines, all COPD patients can be started on a long-acting muscarinic antagonist (LAMA), with treatment increases as needed. Treatments should be tailored based on patient needs. Furthermore, the report recommends LAMA plus long-acting beta-agonist (LABA) as initial treatment option in Group B and Group E COPD patients, with single inhalers being a more convenient/effective option than multiple inhalers.



Data suggest that the LAMA, tiotropium bromide, enhances lung function, slows annual declines in FEV, and decreases the need for rescue inhalers. Moreover, findings from short- and long-term randomized, controlled clinical trials involving tiotropium use in COPD patients have suggested that it is safe and improves health-related quality of life and exercise endurance when compared with placebo or active comparators. It also reduces dyspnea and lung hyperinflation.



Tiotropium bromide inhalation spray is the only LAMA that delivers a soft mist designed to be gentler on damaged lungs because use of the soft mist inhaler (SMI) requires minimal inspiratory effort vs. other inhaler types.



What is your protocol for initiating early treatment in COPD patients? What have your experiences been with tiotropium bromide soft mist inhalation spray?


  • 3yr
    I try to adhere to the GOLD guidelines and usually initiate a LAMA. I find most have been using SABA, so I tend to already introduce a LAMA/LABA combination production Show More
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3yr
High Flow Nasal Cannula Versus Noninvasive Positive Pressure Ventilation as Initial Respiratory Support in Patients with Chronic Obstructive Pulmonary Disease and Covid-19: Exploratory Analysis in Two Intensive Care Units - PubMed

High Flow Nasal Cannula Versus Noninvasive Positive Pressure Ventilation as Initial Respiratory Support in Patients with Chronic Obstructive Pulmonary Disease and Covid-19: Exploratory Analysis in Two Intensive Care Units - PubMed

Source : https://pubmed.ncbi.nlm.nih.gov/36799312/

In critically ill patients with COPD and COVID-19, both HFNC and NPPV were commonly used as the initial mode of ventilation. Switching to a different mode and adverse patient outcomes...



Conclusion: In critically ill patients with COPD and COVID-19, both HFNC and NPPV were commonly used as the initial mode of ventilation. Switching to a different mode and adverse patient outcomes were more frequent in patients initially treated with NPPV. Survivors had higher values of PaO2 /FiO2 than non-survivors.