Kronik Obstrüktif Akciğer Hastalığı ve İlişkili Acilleri
Synopsis
Kronik obstrüktif akciğer hastalığı (KOAH), öksürük, dispne ve hava akımı kısıtlılığı ile karakterize yaygın bir solunum rahatsızlığıdır. Prevalansı ülkeler arasında farklılık gösterse ve yaşla birlikte artsa da, 40 yaş ve üzeri bireylerin yaklaşık yüzde 10'unda KOAH vardır. KOAH, COVID-19 (koronavirüs hastalığı 2019) pandemisinden önce dünya çapında üçüncü önde gelen nedendi. Yüksek prevalansı ve kronikliğinin bir sonucu olarak KOAH, sık klinisyen muayenesi başvurularına, akut alevlenmeler nedeniyle birden fazla hastaneye yatış ve kronik tedavi ihtiyacı nedeniyle yüksek kaynak kullanımına neden olur.
KOAH alevlenmesi, ≤14 gün içinde kötüleşen dispne ve/veya öksürük ve balgamla karakterizedir; takipne ve/veya taşikardi eşlik edebilir ve sıklıkla hava yolu enfeksiyonu, pulmoner emboli, kirlilik veya diğer hava yolu hasarının neden olduğu artan lokal ve sistemik inflamasyonla ilişkilidir.Tedavinin yeri ne olursa olsun, yönetimin hedefleri Kısa etkili inhale bronkodilatörler ve sistemik glukokortikoidler kullanılarak ters hava akımı sınırlaması ; Alevlenmelerin çoğunda rol oynayan enfeksiyonu tedavi edilmesi; uygun oksijenasyonu sağlanması ve hastanın entübasyonu önlenmesidir.
References
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QuickStats: Percentage of Adults Aged ≥18 Years with Diagnosed Chronic Obstructive Pulmonary Disease,† by Urbanization Level§ and Age Group - National Health Interview Survey, United States, 2019. MMWR Morb Mortal Wkly Rep 2021; 70:959.
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Sullivan J, Pravosud V, Mannino DM, et al. National and State Estimates of COPD Morbidity and Mortality - United States, 2014-2015. Chronic Obstr Pulm Dis 2018; 5:324.
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Kochanek KD, Murphy SL, Xu J, Arias E. Mortality in the United States, 2016. NCHS Data Brief 2017; 293. https://www.cdc.gov/nchs/data/databriefs/db293.pdf
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World Health Organization (WHO). Chronic obstructive pulmonary disease. https://www.who.int/news-room/fact-sheets/detail/chronic-obstructive-pulmonary-disease-(copd)
Buist AS, McBurnie MA, Vollmer WM, et al. International variation in the prevalence of COPD (the BOLD Study): a population-based prevalence study. Lancet 2007; 370:741.
Rennard SI, Vestbo J. COPD: the dangerous underestimate of 15%. Lancet 2006; 367:1216.
Castaldi PJ, San José Estépar R, Mendoza CS, et al. Distinct quantitative computed tomography emphysema patterns are associated with physiology and function in smokers. Am J Respir Crit Care Med 2013; 188:1083.
Hersh CP, Washko GR, Estépar RS, et al. Paired inspiratory-expiratory chest CT scans to assess for small airways disease in COPD. Respir Res 2013; 14:42.
Estépar RS, Kinney GL, Black-Shinn JL, et al. Computed tomographic measures of pulmonary vascular morphology in smokers and their clinical implications. Am J Respir Crit Care Med 2013; 188:231.
Aoshiba K, Nagai A. Differences in airway remodeling between asthma and chronic obstructive pulmonary disease. Clin Rev Allergy Immunol 2004; 27:35.
Baraldo S, Turato G, Badin C, et al. Neutrophilic infiltration within the airway smooth muscle in patients with COPD. Thorax 2004; 59:308.
Sutherland ER, Martin RJ. Airway inflammation in chronic obstructive pulmonary disease: comparisons with asthma. J Allergy Clin Immunol 2003; 112:819.
Turato G, Zuin R, Miniati M, et al. Airway inflammation in severe chronic obstructive pulmonary disease: relationship with lung function and radiologic emphysema. Am J Respir Crit Care Med 2002; 166:105.
Cosio MG, Saetta M, Agusti A. Immunologic aspects of chronic obstructive pulmonary disease. N Engl J Med 2009; 360:2445.
Hogg JC. Pathophysiology of airflow limitation in chronic obstructive pulmonary disease. Lancet 2004; 364:709.
Hogg JC, Chu F, Utokaparch S, et al. The nature of small-airway obstruction in chronic obstructive pulmonary disease. N Engl J Med 2004; 350:2645.
Jeffery PK. Comparison of the structural and inflammatory features of COPD and asthma. Giles F. Filley Lecture. Chest 2000; 117:251S.
Harkness LM, Kanabar V, Sharma HS, et al. Pulmonary vascular changes in asthma and COPD. Pulm Pharmacol Ther 2014; 29:144.
Rennard S, Decramer M, Calverley PM, et al. Impact of COPD in North America and Europe in 2000: subjects' perspective of Confronting COPD International Survey. Eur Respir J 2002; 20:799.
Kessler R, Partridge MR, Miravitlles M, et al. Symptom variability in patients with severe COPD: a pan-European cross-sectional study. Eur Respir J 2011; 37:264.
Sin DD, Wu L, Man SF. The relationship between reduced lung function and cardiovascular mortality: a population-based study and a systematic review of the literature. Chest 2005; 127:1952.
Eisner MD, Blanc PD, Yelin EH, et al. COPD as a systemic disease: impact on physical functional limitations. Am J Med 2008; 121:789.
Kjensli A, Falch JA, Ryg M, et al. High prevalence of vertebral deformities in COPD patients: relationship to disease severity. Eur Respir J 2009; 33:1018.
Puente-Maestu L, Pérez-Parra J, Godoy R, et al. Abnormal mitochondrial function in locomotor and respiratory muscles of COPD patients. Eur Respir J 2009; 33:1045.
Barnes PJ, Celli BR. Systemic manifestations and comorbidities of COPD. Eur Respir J 2009; 33:1165.
Swallow EB, Barreiro E, Gosker H, et al. Quadriceps muscle strength in scoliosis. Eur Respir J 2009; 34:1429.
Stolz D, Mkorombindo T, Schumann DM, et al. Towards the elimination of chronic obstructive pulmonary disease: a Lancet Commission. Lancet 2022; 400:921.
Oh YM, Bhome AB, Boonsawat W, et al. Characteristics of stable chronic obstructive pulmonary disease patients in the pulmonology clinics of seven Asian cities. Int J Chron Obstruct Pulmon Dis 2013; 8:31.
Tan WC, Sin DD, Bourbeau J, et al. Characteristics of COPD in never-smokers and ever-smokers in the general population: results from the CanCOLD study. Thorax 2015; 70:822.
Lamprecht B, McBurnie MA, Vollmer WM, et al. COPD in never smokers: results from the population-based burden of obstructive lung disease study. Chest 2011; 139:752.
Qaseem A, Wilt TJ, Weinberger SE, et al. Diagnosis and management of stable chronic obstructive pulmonary disease: a clinical practice guideline update from the American College of Physicians, American College of Chest Physicians, American Thoracic Society, and European Respiratory Society. Ann Intern Med 2011; 155:179.
Bhatt SP, Kim YI, Harrington KF, et al. Smoking duration alone provides stronger risk estimates of chronic obstructive pulmonary disease than pack-years. Thorax 2018; 73:414.
Mannino DM, Gagnon RC, Petty TL, Lydick E. Obstructive lung disease and low lung function in adults in the United States: data from the National Health and Nutrition Examination Survey, 1988-1994. Arch Intern Med 2000; 160:1683.
Mannino DM, Buist AS, Petty TL, et al. Lung function and mortality in the United States: data from the First National Health and Nutrition Examination Survey follow up study. Thorax 2003; 58:388.
Bui DS, Walters HE, Burgess JA, et al. Childhood Respiratory Risk Factor Profiles and Middle-Age Lung Function: A Prospective Cohort Study from the First to Sixth Decade. Ann Am Thorac Soc 2018; 15:1057.
Badgett RG, Tanaka DJ, Hunt DK, et al. Can moderate chronic obstructive pulmonary disease be diagnosed by historical and physical findings alone? Am J Med 1993; 94:188.
Lemyze M, Bart F. Hoover sign. CMAJ 2011; 183:E133.
Garcia-Pachon E, Padilla-Navas I. Frequency of Hoover's sign in stable patients with chronic obstructive pulmonary disease. Int J Clin Pract 2006; 60:514.
NCBI PubChem. Nicotine. http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=89594#x27
Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease: 2024 Report. www.goldcopd.org www.goldcopd.org
Celli BR, Fabbri LM, Aaron SD, et al. An Updated Definition and Severity Classification of Chronic Obstructive Pulmonary Disease Exacerbations: The Rome Proposal. Am J Respir Crit Care Med 2021; 204:1251.
National Institute for Health and Care Excellence (NICE). Chronic obstructive pulmonary disease in over 16s: diagnosis and management (2018). https://www.nice.org.uk/guidance/ng115/chapter/Recommendations#managing-exacerbations-of-copd
Stolz D, Mkorombindo T, Schumann DM, et al. Towards the elimination of chronic obstructive pulmonary disease: a Lancet Commission. Lancet 2022; 400:921.
Hernandez C, Casas A, Escarrabill J, et al. Home hospitalisation of exacerbated chronic obstructive pulmonary disease patients. Eur Respir J 2003; 21:58.
Ojoo JC, Moon T, McGlone S, et al. Patients' and carers' preferences in two models of care for acute exacerbations of COPD: results of a randomised controlled trial. Thorax 2002; 57:167.
Cotton MM, Bucknall CE, Dagg KD, et al. Early discharge for patients with exacerbations of chronic obstructive pulmonary disease: a randomized controlled trial. Thorax 2000; 55:902.
Davies L, Wilkinson M, Bonner S, et al. "Hospital at home" versus hospital care in patients with exacerbations of chronic obstructive pulmonary disease: prospective randomised controlled trial. BMJ 2000; 321:1265.
Skwarska E, Cohen G, Skwarski KM, et al. Randomized controlled trial of supported discharge in patients with exacerbations of chronic obstructive pulmonary disease. Thorax 2000; 55:907.
Ram FS, Wedzicha JA, Wright J, Greenstone M. Hospital at home for patients with acute exacerbations of chronic obstructive pulmonary disease: systematic review of evidence. BMJ 2004; 329:315.
Wedzicha JA Ers Co-Chair, Miravitlles M, Hurst JR, et al. Management of COPD exacerbations: a European Respiratory Society/American Thoracic Society guideline. Eur Respir J 2017; 49.
National Institute for Health and Care Excellence (NICE). Chronic obstructive pulmonary disease in over 16s - Diagnosis and management (2018, updated 2019). https://www.nice.org.uk/guidance/ng115 (Accessed on March 23, 2020).
Cydulka RK, Emerman CL. Effects of combined treatment with glycopyrrolate and albuterol in acute exacerbation of chronic obstructive pulmonary disease. Ann Emerg Med 1995; 25:470.
In chronic obstructive pulmonary disease, a combination of ipratropium and albuterol is more effective than either agent alone. An 85-day multicenter trial. COMBIVENT Inhalation Aerosol Study Group. Chest 1994; 105:1411.
O'Driscoll BR, Taylor RJ, Horsley MG, et al. Nebulised salbutamol with and without ipratropium bromide in acute airflow obstruction. Lancet 1989; 1:1418.
McCrory DC, Brown CD. Anti-cholinergic bronchodilators versus beta2-sympathomimetic agents for acute exacerbations of chronic obstructive pulmonary disease. Cochrane Database Syst Rev 2002; :CD003900.
Levin DC, Little KS, Laughlin KR, et al. Addition of anticholinergic solution prolongs bronchodilator effect of beta 2 agonists in patients with chronic obstructive pulmonary disease. Am J Med 1996; 100:40S.
Aaron SD, Vandemheen KL, Hebert P, et al. Outpatient oral prednisone after emergency treatment of chronic obstructive pulmonary disease. N Engl J Med 2003; 348:2618.
Leuppi JD, Schuetz P, Bingisser R, et al. Short-term vs conventional glucocorticoid therapy in acute exacerbations of chronic obstructive pulmonary disease: the REDUCE randomized clinical trial. JAMA 2013; 309:2223.
Pleasants RA, Wang T, Xu X, et al. Nebulized Corticosteroids in the Treatment of COPD Exacerbations: Systematic Review, Meta-Analysis, and Clinical Perspective. Respir Care 2018; 63:1302.
Ding Z, Li X, Lu Y, et al. A randomized, controlled multicentric study of inhaled budesonide and intravenous methylprednisolone in the treatment on acute exacerbation of chronic obstructive pulmonary disease. Respir Med 2016; 121:39.
Ställberg B, Selroos O, Vogelmeier C, et al. Budesonide/formoterol as effective as prednisolone plus formoterol in acute exacerbations of COPD. A double-blind, randomised, non-inferiority, parallel-group, multicentre study. Respir Res 2009; 10:11.
Stoller JK. Clinical practice. Acute exacerbations of chronic obstructive pulmonary disease. N Engl J Med 2002; 346:988.
Moayyedi P, Congleton J, Page RL, et al. Comparison of nebulised salbutamol and ipratropium bromide with salbutamol alone in the treatment of chronic obstructive pulmonary disease. Thorax 1995; 50:834.
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Volume
Pages
57-84
Published
May 3, 2024
Copyright (c) 2024 Academician Publishing Book Portal
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1.
Beşer Z. Kronik Obstrüktif Akciğer Hastalığı ve İlişkili Acilleri. In: Akman C, Karcıoğlu Ö, editors. Dahili Aciller [Internet]. Türkiye: Academician Publishing Book DOI Portal; 2024 [cited 2026 Jul. 13]. pp. 57-84. Available from: https://omp35.books.akademisyen.net/index.php/akya/catalog/book/3074/chapter/13160
