Copd Case Studies

5412 Words22 Pages
Chronic Obstructive Pulmonary Disease: Acute Exacerbation Introduction There are currently over 900,000 people in England who have been diagnosed with chronic obstructive pulmonary disease (COPD). COPD is currently the only major disease whose incidence and prevalence is predicted to rise over the next twenty years. This rise is expected to occur because COPD is a long latency disease whose symptoms become apparent many years after the first exposure to the causative agent, which means the majority of people affected are either middle aged or elderly. However, studies by Soriano et al (2000) suggest that COPD is under diagnosed in general practice and the true prevalence could be as high as 1.5-3million (National Institute of Clinical…show more content…
ROS and RNS are generated in the lower respiratory tract as products of normal cellular metabolism. Neutrophil-induced oxidative damage, release of profibrotic neuropeptides such as bombesin and reduced levels of vascular endothelial growth factor may contribute to apoptotic destruction of lung parenchyma. This process may be accelerated during acute exacerbations. There has been a great deal of debate in the literature (GOLD, 2009; Rabe et al, 2007; MacNee, 2003; Rodriguez & Roisin, 2000) surrounding the development of a universal definition of acute exacerbation and the pathophysiology of an acute exacerbation is still not completely understood. NICE (2010) define an exacerbation as sustained worsening of the patients symptoms from their usual state which is beyond normal day to day variations and is acute in onset. Often a change in symptoms necessitates a change in medication. GOLD (2009) state that an acute exacerbation occurs in response to either bacterial or viral infection or environmental irritants. During exacerbations the pattern of inflammatory cells changes with an increase in…show more content…
Extrinsic factors include airway infection and increased air pollution and intrinsic factors such as increased oxidative stress and altered immunity (Tsoumakidou & Siafakas, 2006), although the exact mechanisms are not known (Bathoorn et al, 2008). Ball (1995) states that infections play a major role in the aetiology of acute exacerbations. It is known that patients with COPD have significant impairment of the lung defence mechanisms and colonisation of the bronchial system seems to be an important consequence of the disease, particularly in exacerbations according to Erkan et al (2008). Discussion The prevalence of COPD appears to increase with age according to Devereux (2006) and Soriano (2000). However, it is interesting that they attribute this increase solely to aetiological factors rather than the normal process of ageing. Some of the reduction in lung function may be due to age as well as the pathophysiological changes associated with COPD (McCance & Huether, 2006). As age advances according to McCance & Huether (2006) degenerative physiological changes occur, leading to normal alterations in lung function. These alterations include loss of elastic recoil, stiffening of the chest wall, alterations in gaseous exchange due to loss of tissue from the alveolar walls and increases in flow resistance reducing ventilatory capacity. When combined with polypharmacy that may cause respiratory depression, which is common in the elderly, it could

More about Copd Case Studies

Open Document