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MECHANICAL VENTILATION IN COPD SPEAKER :DR.GOOLAPPA MODERATOR: DR.HARISH R.D.T HOSPITAL, BTP.
DEFINITION OF COPD ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
2 . CHRONIC BRONCHITIS 1. EMPHYSEMA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
SMOKING - THE CULPRIT
RISK FACTORS FOR COPD ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],MOST IMP RISK
CLINICAL FEATURES
CHRONIC BRONCHITIS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],EMPHYSEMA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CHRONIC BRONCHITIS EMPHYSEMA BLUE BLOTTER PINK PUFFER
ALPHA 1 ANTITRYPSIN ↓ ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],EMPHYSEMA
CLINICAL SIGNS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],SPIROMETRY
MRC DYSPNOEA SCALE Too breathless to leave house or breathless while dressing 4 Stops for breath on walking 100 m or after 2 or 3 minutes continuously 3 Walks slower than contemporaries or has to stop for breath while walking alone 2 Short of breath when walking uphill or while hurrying to catch a bus or train 1 No breathlessness except on strenuous exercise 0 Degree of breathlessness - related activity Grade
DIFF. Dx. of COPD & ASTHMA Change > 15% Change < 15% Reversibility ICS IBD (Ipa+Salm) Most IMP Rx. Normal or Obstru. Obstructive Spirometry Useful ad on Rx. Not useful Anti leukotrn. Variable, static Progressive Course Episodic Persistent Dyspnea Mucoid or none Productive Sputum Nearly all Rare Age < 35 May or may not be Nearly all Smoker ASTHMA COPD Clinical
CHEST SKIAGRAMS OF EMPHYSEMA
CHEST SKIAGRAM OF CHRONIC BRONCHITIS
CHEST LATERAL VIEW CHRONIC BRONCHITIS
ASSESSMENT OF COPD ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
NORMAL AND COPD SPIROMETRY
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],MANAGEMENT - IBD
Pledge to stop smoking
Why use ventilatory assistance ? ,[object Object],[object Object],[object Object],[object Object]
Limitations of invasive ventilation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Limitations of NPPV ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Current Recommendations - NPPV in ARF ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
NPPV in COPD ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
NPPV in acute COPD – results ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
NPPV – How to Make it work in ARF ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Contraindications ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Interfaces:-Nasal & Full Face masks
Implementation - Hypercapnoeic RF ,[object Object],[object Object],[object Object],[object Object],[object Object]
Monitoring ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Weaning in Acute COPD Exacerbation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
The Decision To Intubate ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Goals for COPD patients ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Vent Guidelines ,[object Object],[object Object]
Vent Guidelines ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Summary ,[object Object],[object Object],[object Object],[object Object]
References ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
THANK YOU

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G M C F I N A L

  • 1. MECHANICAL VENTILATION IN COPD SPEAKER :DR.GOOLAPPA MODERATOR: DR.HARISH R.D.T HOSPITAL, BTP.
  • 2.
  • 3.
  • 4. SMOKING - THE CULPRIT
  • 5.
  • 7.
  • 8. CHRONIC BRONCHITIS EMPHYSEMA BLUE BLOTTER PINK PUFFER
  • 9.
  • 10.
  • 11. MRC DYSPNOEA SCALE Too breathless to leave house or breathless while dressing 4 Stops for breath on walking 100 m or after 2 or 3 minutes continuously 3 Walks slower than contemporaries or has to stop for breath while walking alone 2 Short of breath when walking uphill or while hurrying to catch a bus or train 1 No breathlessness except on strenuous exercise 0 Degree of breathlessness - related activity Grade
  • 12. DIFF. Dx. of COPD & ASTHMA Change > 15% Change < 15% Reversibility ICS IBD (Ipa+Salm) Most IMP Rx. Normal or Obstru. Obstructive Spirometry Useful ad on Rx. Not useful Anti leukotrn. Variable, static Progressive Course Episodic Persistent Dyspnea Mucoid or none Productive Sputum Nearly all Rare Age < 35 May or may not be Nearly all Smoker ASTHMA COPD Clinical
  • 13. CHEST SKIAGRAMS OF EMPHYSEMA
  • 14. CHEST SKIAGRAM OF CHRONIC BRONCHITIS
  • 15. CHEST LATERAL VIEW CHRONIC BRONCHITIS
  • 16.
  • 17. NORMAL AND COPD SPIROMETRY
  • 18.
  • 19. Pledge to stop smoking
  • 20.
  • 21.
  • 22.
  • 23.
  • 24.
  • 25.
  • 26.
  • 27.
  • 28.
  • 29.
  • 31.
  • 32.
  • 33.
  • 34.
  • 35.
  • 36.
  • 37.
  • 38.
  • 39.
  • 40.