Salvi Sundeep, Ghorpade Deesha, Nair Sanjeev, Pinto Lancelot, Singh Ashok K, Venugopal K, Dhar Raja, Talwar Deepak, Koul Parvaiz, Prabhudesai Pralhad
Pulmocare Research and Education Foundation, Pune, India.
Symbiosis Medical College for Women and Symbiosis University Hospital and Research Centre, Symbiosis International (Deemed University), Pune, India.
NPJ Prim Care Respir Med. 2024 Dec 20;34(1):44. doi: 10.1038/s41533-024-00378-7.
Acute exacerbations of COPD (ECOPD) are an important event in the life of a COPD patient as it causes significant deterioration of physical, mental, and social health, hastens disease progression, increases the risk of dying and causes a huge economic loss. Preventing ECOPD is therefore one of the most important goals in the management of COPD. Before the patient is discharged after hospitalization for ECOPD, it is crucial to offer an evidence-based care bundle protocol that will help minimize the future risk of readmissions and death. To develop the content of this quality care bundle, an Expert Working Group was formed, which performed a systematic review of literature, brainstormed, and debated on key clinical issues before arriving at a consensus strategy that could help physicians achieve this goal. A 7-point consensus strategy was prepared, which included: (1) enhancing awareness and seriousness of ECOPD, (2) identifying patients at risk for future exacerbations, (3) optimizing pharmacologic treatment of COPD, (4) identifying and treating comorbidities, (5) preventing bacterial and viral infections, (6) pulmonary rehabilitation, and (7) palliative care. Physicians may find this 7-point care bundle useful to minimize the risk of future exacerbations and reduce morbidity and mortality.
慢性阻塞性肺疾病急性加重(ECOPD)是慢性阻塞性肺疾病患者生活中的一个重要事件,因为它会导致身体、心理和社会健康状况显著恶化,加速疾病进展,增加死亡风险,并造成巨大的经济损失。因此,预防ECOPD是慢性阻塞性肺疾病管理中最重要的目标之一。在因ECOPD住院的患者出院前,提供基于证据的护理包方案至关重要,这将有助于最大限度地降低未来再次入院和死亡的风险。为了制定这个优质护理包的内容,成立了一个专家工作组,该工作组对文献进行了系统回顾,就关键临床问题进行了头脑风暴和辩论,然后达成了一项有助于医生实现这一目标的共识策略。制定了一项七点共识策略,包括:(1)提高对ECOPD的认识和重视程度,(2)识别未来有急性加重风险的患者,(3)优化慢性阻塞性肺疾病的药物治疗,(4)识别和治疗合并症,(5)预防细菌和病毒感染,(6)肺康复,以及(7)姑息治疗。医生可能会发现这个七点护理包有助于最大限度地降低未来急性加重的风险,并降低发病率和死亡率。