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Updated: Dec 13, 2025
07:10
Home-Based Prescribed Pulmonary Exercise in Patients with Stable Chronic Obstructive Pulmonary Disease
Published on: August 24, 2019
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Pre-operative optimisation for chronic obstructive pulmonary disease: a narrative review
A H Y Lee1, C P Snowden2,3, N S Hopkinson4,5
1Nuffield Department of Clinical Neurosciences, University of Oxford, UK.
Anaesthesia
|July 26, 2020
Summary
Optimizing care for patients with chronic obstructive pulmonary disease (COPD) before surgery is crucial. This review highlights pulmonary rehabilitation and the
Area of Science:
- Pulmonary Medicine
- Surgical Care
- Critical Care
Background:
- Chronic obstructive pulmonary disease (COPD) is prevalent in surgical patients, increasing risks of complications and mortality.
- COPD often presents with extra-pulmonary manifestations and comorbidities, impacting quality of life and functional ability.
- Optimizing peri-operative care for COPD patients is essential for improving clinical outcomes.
Purpose of the Study:
- To review evidence on optimizing peri-operative care for individuals with COPD.
- To discuss the role of pulmonary rehabilitation in the peri-operative setting.
- To address potential new interventions for improving outcomes in surgical COPD patients.
Main Methods:
- Review of existing literature on peri-operative COPD management.
- Focus on pulmonary rehabilitation and its application in pre-surgical care.
- Analysis of the 'five fundamentals' of COPD treatment: smoking cessation, pulmonary rehabilitation, vaccination, self-management, and comorbidity optimization.
Main Results:
- Current evidence for peri-operative interventions is often of high risk of bias.
- Pulmonary rehabilitation, while standard for stable COPD, is underutilized pre-operatively.
- Optimization of pharmacological treatment and consideration of lung volume reduction surgery may benefit some patients.
Conclusions:
- Achieving the 'five fundamentals' of COPD management before surgery is critical.
- Pulmonary rehabilitation and addressing psychological factors are key areas for improvement in peri-operative COPD care.
- Balancing surgical urgency with pre-operative optimization requires individualized patient assessment.
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