First, how to identify the acute exacerbation of COPD?
The acute exacerbation period of COPD is that the symptoms become worse than the remission period, and the treatment plan needs to be adjusted. In the short term, the patient’s cough, sputum or shortness of breath worsened, and the amount of sputum increased, which was purulent or sticky purulent, and the inflammation such as fever could be significantly worsened. These changes exceeded the daily changes on weekdays.
Second, What should I do after the acute exacerbation of COPD patients?
1. Once COPD has an acute attack, see a doctor in time. Patients with milder illness in the early stage can be treated outside the hospital, but special attention should be paid to changes in the condition. If the condition does not ease or progresses after treatment, they should be sent to the hospital in time to avoid delay in treatment.
2. Patients with pus and sputum accompanied by increased sputum volume or increased shortness of breath, or when mechanical ventilation is needed should be given antibiotics. It should be carried out under the guidance of a doctor. The use should be timely, effective and sufficient. The course of treatment is 1 to 2 weeks. It should be stopped immediately after infection control. Do not take medicine irregularly, stop eating and eating, this will make the course of the disease difficult to heal. Avoid long-term abuse of antibiotics after infection control, which will lead to imbalance of flora and increase of resistant bacteria. It is not advisable to use antitussive drugs alone, but mainly to reduce sputum, otherwise the sputum is not easy to be discharged, and instead promotes the infection to worsen.
Third, how to treat chronic obstructive pulmonary disease during stable period?
An individualized comprehensive treatment plan should be formulated according to individual circumstances to prevent further deterioration of heart and lung function, improve quality of life, and prolong survival.
(1) Long-term home oxygen therapy.
According to the relationship between the concentration of inhaled oxygen and the flow rate, a 5-liter oxygen concentrator inhales 41% of the oxygen in the patient’s body. This is an ideal value. In fact, the oxygen inhaled by a 5-liter machine in patients with COPD is more than 30% That is, the doctor said that oxygen with a low oxygen concentration of about 30 is required for discharge, which refers to a 5 liter oxygen concentrator, so patients with respiratory diseases such as chronic obstructive pulmonary disease, especially lung disease, use 5 liters or 10 liters. The patient’s blood oxygen saturation is above 90% (critically ill patients generally can be 94%) as the goal. For example, patients with COPD use a 5 liter machine but the blood oxygen saturation is below 90, then a large flow oxygen concentrator with a volume of 5 liters or more is used. Oxygen therapy time: from 7 to 8 hours per day to more than ten hours, and very severe over 20 hours. The oxygen concentrator used with the ventilator has a flow rate of more than 5 liters to have an effect on the patient. The performance of the oxygen concentrator requires 24 hours of continuous oxygen supply. The humidifier bottle cannot be filled with water. The ventilator must have a dedicated oxygen line for oxygen delivery. The tube is preferably connected to a dedicated oxygen port of the breathing mask.
(2) Take medicine. According to the severity of the disease, bronchodilators, inhaled glucocorticoids and expectorants are used to control cough, sputum, asthma, palpitations, shortness of breath, and edema.
(3) Keep warm everyday. After entering the winter, the temperature is significantly reduced, and the COPD patients have poor physical resistance. In addition, dry and cold air stimuli often worsen the disease. COPD is irreversible. A cold worsens once, so COPD patients must keep warm.
(4) Maintain respiratory hygiene. Including smoking cessation, postural drainage, cough training, aerosolized inhalation and other methods to fully drain airway secretions and keep the lumen unobstructed.
(5) Enhance resistance by breathing training and physical training.