The lung is located in the chest cavity and is the most important organ of respiration. It consists of two separate parts located on the right and left sides of the thoracic cavity. The right lung has 3 lobes and the left lung has 2 lobes. It consists of spaces called lung sacs (alveoli) filled with air. The air in the sacs combines with the atmospheric air through the bronchioles, bronchi, trachea, larynx, pharynx, mouth and nasal passages.
COPD (chronic obstructive pulmonary disease) is a lung disease. Since it is a lung disease, it can seriously affect breathing. It is not contagious. COPD is usually caused by the destruction of the alveoli that make up the lungs. It is a chronic, irreversible and progressive disease that occurs in the lungs as a result of inhaling harmful gases for a long time, develops due to chronic bronchitis and emphysema, and is characterized by airflow limitation. It can be confused with some other respiratory diseases. To be able to say that a patient with chronic bronchitis or emphysema has developed COPD, chronic airflow limitation must have occurred. With the restriction of breathing, problems such as not getting enough oxygen to the body and not being able to remove enough carbon dioxide from the body may occur. For its solution, devices such as oxygen cylinder, oxygen concentrator, BPAP and BPAP ST can be used by adjusting the appropriate parameters.
What is COPD?
K » Chronic » Continuous
O » Obstructive » Obstructive
A » Lung
H » disease
COPD is a disease of older age. It is more common in men. In a study conducted in our country in people over the age of 40, the incidence of COPD was found to be much higher than the world average. The reason for this can be briefly explained as the use of tobacco products and long-term inhalation of harmful gases.
What are the COPD Findings?
Cough and sputum complaints are present from the onset of COPD. These complaints increase over time, and shortness of breath and wheezing are added to them. The cough is mild at first and worsens in the morning. The patient is relieved by expelling sputum. As the disease progresses, the cough intensifies, the sputum thickens. on sputum streak of blood visible.
As COPD progresses, a lack of oxygen in the body may also develop. For this reason, bruising can be seen on the hands, feet and face. Chronic oxygen problem and recurrent coughing attacks can also cause heart failure in the future. Patients usually have a wide barrel chest. The anterior and posterior diameters of the patient's rib cage have increased. The accessory respiratory muscles in the neck have become prominent and their movements can be observed while breathing. While the patient is resting, respiratory sounds decrease, heart sounds are heard deeply and lightly. The exhalation phase of breathing is prolonged in patients with COPD.
Every year, 3 million people die from this disease in the world. While a decrease was observed in some other diseases, the incidence of COPD increased by 163%. According to the World Health Organization data, it is the 4th most common disease in the world and causes millions of deaths every year. If precautions are not taken, it can rise to the top of the list years later and become the most common killer disease in the world.
It is one of the most deadly diseases in Turkey as well as in the world. It is a disease of older age and is more common in men. The incidence increases in people over 40 years of age. Who does not know that his respiratory problems are caused by COPD? millions available. Public awareness of this disease is still not at a sufficient level.
Chest X-ray and pulmonary function tests are performed in patients who apply to the hospital with symptoms such as chronic cough, sputum production and shortness of breath. Apart from these, EKG and complete blood count tests can also be performed. Findings related to COPD can be detected on chest X-ray. Pulmonary function tests, on the other hand, provide objective confirmation of the diagnosis of COPD and determination of its severity.
What are the Causes of COPD?
- Use of tobacco products
- Use of alcoholic products
- Air pollution
- Occupational factors
- Socioeconomic conditions
- Respiratory infections
- Gene pool
- Diseases that cause damage to the lung
What is the Importance of Oxygen Therapy in COPD?
Currently, there is no treatment that will completely eliminate COPD. Some medications, however, can only slow the progression of the disease. The most important factor that slows the progression of the disease is to quit using tobacco products and to stay away from places with air pollution. Because the oxygen pressure in the blood of a patient with COPD decreases, enough oxygen cannot reach the body tissues. from lack of oxygen brain first. Many vital organs such as heart and kidney may be damaged. "Oxygen therapy" can be applied to increase the pressure and amount of oxygen in the patient's blood. Applying this treatment randomly can cause bigger problems. Appropriate oxygen device should be determined and used with appropriate treatment parameters.
Oxygen therapy provides respiratory support to patients who cannot get enough oxygen and reduces the respiratory distress of the patients to some extent. In this way, it extends the comfort and life span of patients. With treatment, the patient's pulmonary vascular pressure decreases, sleep quality improves, muscle and skeletal structure improves, and the number of increased red blood cells in the patient's blood returns to normal. Thus, the problem of shortness of breath decreases in a short time and patients feel better. Correct and uninterrupted application of oxygen therapy also allows to reduce the number and duration of hospitalizations.
There are certain criteria for long-term oxygen therapy. Criteria such as blood oxygen pressure (paO2) below 60 mmHg and oxygen saturation (SpO2) below 90%, pulmonary hypertension (lung high blood pressure) with edema in the legs, red blood cells above 55% and risk of heart failure. Oxygen therapy may be used if available. Apart from these criteria, the patient's age, physical condition and other existing diseases are also taken into consideration. Oxygen therapy may not be applied to all COPD patients. Physicians make the treatment decision by evaluating all the parameters of the patient.
While adjusting the dose and duration of oxygen therapy according to the patient, the carbon dioxide pressure in the blood (paCO3) and the pH value of the blood should also be taken into account. Indiscriminate oxygen therapy may harm the patient. Oxygen therapy for COPD also during sleep should be continued. In this way, the effects of rhythm disturbance and increased blood pressure, which may cause a decrease in oxygen pressure (paO2) during sleep, are reduced. Studies show that the longer the treatment period, the longer the patient's life expectancy. For example, when a study is conducted among patients who need to take oxygen for 19 hours a day, when the patients who receive oxygen for 19 hours, including sleep, and those who receive oxygen for 12 hours during the daytime they are awake, two years later, it is examined whether they are alive or not, compared to those in the other group who receive oxygen for 19 hours. long lived.
The oxygen pressure (paO2) in the blood of patients with COPD is already low; It decreases even more in COPD attacks. This can practically be understood from the bruising of the patient's nails and lips. In addition, with devices called pulse oximeters, oxygen measurement can be made from the finger. Thus, the oxygen rate in the patient's body can be detected instantly. If this ratio falls below 90%, it is an indication of insufficient oxygen in the blood. A more reliable method is the measurement of oxygen pressure (paO2) in arterial blood. Measurement with pulse oximetry can be done anywhere, but measurement of oxygen pressure in arterial blood requires a laboratory environment. The carbon dioxide pressure (paCO3) and pH value of the blood can also be determined with the measurement made by taking samples from the arterial blood. A decrease in oxygen pressure (paO2) below 60 mmHg is considered as an indication of insufficient oxygen supply to the patient's body tissues. Oxygen therapy should be applied to these patients and the oxygen pressure should be increased above 60. The oxygen flow rate should generally be adjusted to 1-2 liters per minute during the treatment. Although this setting varies according to the patient's condition, it is generally not recommended to exceed 2 liters per minute.
Long-term oxygen therapy in COA patients is done with oxygen concentrators and oxygen cylinders. Oxygen concentrators that can be used in homes and clinics are divided into 5 main categories according to their capacities and features. Oxygen cylinders are 30 types according to their capacities and features. For the treatment of the patient, products suitable for respiratory needs should be determined and used.
Oxygen Concentrator Types
- 3L / min Oxygen Concentrator
- 5L / min Oxygen Concentrator
- 10L / min Oxygen Concentrator
- Portable Oxygen Concentrator
- Personal Oxygen Station
Oxygen Cylinder Types
- 1 Liter Pin Index Aluminum Oxygen Cylinder
- 1 Liter Aluminum Oxygen Cylinder with Valve
- 1 Liter Steel Oxygen Cylinder with Valve
- 2 Liter Pin Index Aluminum Oxygen Cylinder
- 2 Liter Aluminum Oxygen Cylinder with Valve
- 2 Liter Steel Oxygen Cylinder with Valve
- 3 Liter Pin Index Aluminum Oxygen Cylinder
- 3 Liter Aluminum Oxygen Cylinder with Valve
- 3 Liter Steel Oxygen Cylinder with Valve
- 4 Liter Pin Index Aluminum Oxygen Cylinder
- 4 Liter Aluminum Oxygen Cylinder with Valve
- 4 Liter Steel Oxygen Cylinder with Valve
- 5 Liter Pin Index Aluminum Oxygen Cylinder
- 5 Liter Aluminum Oxygen Cylinder with Valve
- 5 Liter Steel Oxygen Cylinder with Valve
- 10 Liter Pin Index Aluminum Oxygen Cylinder
- 10 Liter Aluminum Oxygen Cylinder with Valve
- 10 Liter Steel Oxygen Cylinder with Valve
- 20 Liter Pin Index Aluminum Oxygen Cylinder
- 20 Liter Aluminum Oxygen Cylinder with Valve
- 20 Liter Steel Oxygen Cylinder with Valve
- 27 Liter Pin Index Aluminum Oxygen Cylinder
- 27 Liter Aluminum Oxygen Cylinder with Valve
- 27 Liter Steel Oxygen Cylinder with Valve
- 40 Liter Pin Index Aluminum Oxygen Cylinder
- 40 Liter Aluminum Oxygen Cylinder with Valve
- 40 Liter Steel Oxygen Cylinder with Valve
- 50 Liter Pin Index Aluminum Oxygen Cylinder
- 50 Liter Aluminum Oxygen Cylinder with Valve
- 50 Liter Steel Oxygen Cylinder with Valve
What is the Importance of PAP Treatment in COPD?
PAP devices that can be used for the treatment of COPD are generally BPAP and BPAP ST. BPAP devices, also called Bilevel CPAP devices, can be used in the treatment of upper respiratory tract or lung diseases. These devices with non-invasive respiratory masks is applied. Providing respiratory support with the help of a mask without making a hole in the trachea is called non-invasive mechanical ventilation.
What are Non-Invasive Respirators?
- Nose Padded Mask
- Nasal Cannula
- Nasal Mask
- Oral Mask
- Ora-Nasal Mask
- Whole Face Mask
BPAP and BPAP ST devices Although they are very similar in terms of working style, there are differences between them in terms of several parameters. Both devices generate two-stage, continuous positive airway pressure. Two-stage airway pressure means different pressures are applied while the person inhales (IPAP) and exhales (EPAP). The difference between IPAP and EPAP is the general feature of BPAP devices. However, BPAP ST devices also have adjustable I/E and frequency parameters. In this way, the duration parameter of the given respiratory support can also be adjusted. The difference between BPAP and BPAP ST is that the time parameter can be adjusted in BPAP ST devices.
I/E = Inspiratory time/expiratory time = Inspiratory time/expiratory time = Inspiratory time/expiratory time = It is the ratio of inspiratory time to expiratory time. The I/E ratio in a healthy adult is usually 1/2.
Frequency = Rate = Number of breaths per minute. Normal respiratory rate in adults is usually between 8-14 per minute. It is higher in children.
IPAP = Inspiratory positive airway pressure = Inspiratory airway pressure = Pressure in the airway during breathing. In some devices it is designated as “Pi”.
EPAP = Expiratory positive airway pressure = Expiratory airway pressure = Pressure formed in the airway during exhalation. In some devices it is indicated as “Pe”.
In BPAP devices, a lower pressure is applied during the exhalation phase than during the inhale phase, instead of a single constant pressure parameter. This creates a pressure difference in the lung. The pressure difference created allows the patient to breathe more easily. Decreased pressure, especially during the exhalation phase carbon dioxide gas accumulating in the lungs It also makes it easy to throw out. In addition, the application of variable pressure instead of a constant pressure allows the patient to give more positive results to the treatment applied with PAP devices.
BPAP devices are generally used in the following 3 situations:
- In case of obesity-related hypoventilation
- When you have a lung-related disease such as COPD
- In patients who cannot adapt to CPAP devices
BPAP and BPAP ST devices can also be used with oxygen concentrators and oxygen cylinders. In this way, the extra oxygen support needed by the patient can be provided.