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Latest & greatest articles for copd exacerbations
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evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology An Acute Respiratory Assessment Service (ARAS), for the management of patients with exacerbations of chronicobstructivepulmonarydisease (COPD) at home after supported discharge, was examined. The ARAS was available on weekdays from 9.00 a.m (...) in ARAS patients. Synthesis of costs and benefits Not relevant because a cost-consequences analysis was conducted. Authors' conclusions The Acute Respiratory Assessment Service (ARAS) represented an effective and efficient alternative to conventional care for the management of patients with exacerbations of chronicobstructivepulmonarydisease (COPD). The hospital costs were far lower and both the patients and general practitioner (GPs) were satisfied. CRD COMMENTARY - Selection of comparators
, Ahmed A A, Fenwick L J, et al. Comparison of the acute effects on gas exchange of nasal ventilation and doxapram in exacerbations of chronicobstructivepulmonarydisease. Thorax 1996;51: 1048-1050. 2. Avdeev S N, Tret'iakov AV, Grigor'iants RA, et al. Study of the use of non-invasive ventilation of the lungs in acute respiratory insufficiency due to exacerbation of chronicobstructivepulmonarydisease. Anesteziol Reanimatol 1998;3:45-51. 3. Celikel T, Sungur M, Ceyhan B, et al. Comparison of non (...) standard therapy in cases of acute exacerbations of chronicobstructivepulmonarydisease. NPPV is usually provided for a minimum of 8 hours on the first day and reduced gradually during the next few days. Type of intervention Treatment. Economic study type Cost-effectiveness analysis. Study population The study population was patients with acute, severe exacerbations of chronicobstructivepulmonarydisease (COPD), as identified by increased shortness of breath with or without cough and wheeze
Oral corticosteroids in patients admitted to hospital with exacerbations of chronicobstructivepulmonarydisease: a prospective randomised controlled trial. The role of oral corticosteroids in treating patients with exacerbations of chronicobstructivepulmonarydisease (COPD) remains contentious. We assessed in a prospective, randomised, double-blind, placebo-controlled trial the effects of oral corticosteroid therapy in patients with exacerbations of COPD requiring hospital admission.We (...) recruited patients with non-acidotic exacerbations of COPD who were randomly assigned oral prednisolone 30 mg once daily (n=29) or identical placebo (n=27) for 14 days, in addition to standard treatment with nebulised bronchodilators, antibiotics, and oxygen. We did spirometry and recorded symptom scores daily in inpatients. Time to discharge and withdrawals were noted in each group. We recalled patients at 6 weeks to repeat spirometry and collect data on subsequent exacerbations and treatment. Hospital
1999LancetControlled trial quality: predicted high
Effect of systemic glucocorticoids on exacerbations of chronicobstructivepulmonarydisease. Department of Veterans Affairs Cooperative Study Group. Although their clinical efficacy is unclear and they may cause serious adverse effects, systemic glucocorticoids are a standard treatment for patients hospitalized with exacerbations of chronicobstructivepulmonarydisease (COPD). We conducted a double-blind, randomized trial of systemic glucocorticoids (given for two or eight weeks) or placebo (...) in addition to other therapies, for exacerbations of COPD. Most other care was standardized over the six-month period of follow-up. The primary end point was treatment failure, defined as death from any cause or the need for intubation and mechanical ventilation, readmission to the hospital for COPD, or intensification of drug therapy.Of 1840 potential study participants at 25 Veterans Affairs medical centers, 271 were eligible for participation and were enrolled; 80 received an eight-week course
Noninvasive ventilation for acute exacerbations of chronicobstructivepulmonarydisease. In patients with acute exacerbations of chronicobstructivepulmonarydisease, noninvasive ventilation may be used in an attempt to avoid endotracheal intubation and complications associated with mechanical ventilation.We conducted a prospective, randomized study comparing noninvasive pressure-support ventilation delivered through a face mask with standard treatment in patients admitted to five intensive (...) mortality rate was also significantly reduced with noninvasive ventilation (4 of 43 patients, or 9 percent, in the noninvasive-ventilation group died in the hospital, as compared with 12 of 42, or 29 percent, in the standard-treatment group; P = 0.02).In selected patients with acute exacerbations of chronicobstructivepulmonarydisease, noninvasive ventilation can reduce the need for endotracheal intubation, the length of the hospital stay, and the in-hospital mortality rate.
(or erythromycin 500mg qid if allergic) and oral ciprofloxacin 500mg bd as second line treatment. Type of intervention Treatment. Economic study type Cost-effectiveness analysis. Study population Patients with a discharge diagnosis of infective exacerbation of chronicobstructiveairwaysdisease (COAD). The patients in the two groups were around 60 years old. Setting The clinical and economic studies were set in a regional respiratory unit at a hospital in Dundee, UK. Dates to which data relate (...) Evaluation of an antibiotic prescribing protocol for treatment of acute exacerbations of chronicobstructiveairwaysdisease in a hospital respiratory unit Evaluation of an antibiotic prescribing protocol for treatment of acute exacerbations of chronicobstructiveairwaysdisease in a hospital respiratory unit Evaluation of an antibiotic prescribing protocol for treatment of acute exacerbations of chronicobstructiveairwaysdisease in a hospital respiratory unit Boyter A C, Davey P G, Hudson S