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Management of Refractory Chronic Obstructive Pulmonary Disease: A Review
Mandeep Singh Rahi1, Mayuri Mudgal2, Bharat Kumar Asokar3
1Division of Pulmonary Diseases and Critical Care Medicine, Yale-New Haven Health Lawrence and Memorial Hospital, New London, CT 06320, USA.
Life (Basel, Switzerland)
|May 25, 2024
Summary
Chronic obstructive pulmonary disease (COPD) management often fails for some patients. This review explores advanced therapies and supportive care for refractory COPD, aiming to improve patient outcomes.
Area of Science:
- Pulmonology
- Respiratory Medicine
Background:
- Chronic obstructive pulmonary disease (COPD) affects over 12% of adults globally, causing significant morbidity and mortality.
- While many patients respond to standard treatments, a subset develops refractory COPD with persistent symptoms.
- Refractory COPD lacks a formal definition but is characterized by severe symptoms despite optimal care.
Purpose of the Study:
- To review current and emerging interventions for managing refractory COPD.
- To discuss a multidimensional approach encompassing pharmacologic, non-pharmacologic, and advanced therapies.
- To highlight upcoming treatments and palliative care strategies for refractory COPD patients.
Main Methods:
- This is a review article synthesizing existing literature on refractory COPD management.
- Key interventions discussed include inhaler technique, non-invasive ventilation, chronic antibiotics, phosphodiesterase inhibitors, and bronchoscopic lung volume reduction surgery.
- The review also covers anti-IL5 agents, psycho-social support, nutritional support, and palliative care.
Main Results:
- Standard COPD interventions are insufficient for patients with refractory disease.
- A range of advanced therapies and supportive measures are available and under investigation.
- Multidimensional management is crucial for improving outcomes in refractory COPD.
Conclusions:
- Effective management of refractory COPD requires a comprehensive strategy beyond standard care.
- Emerging therapies, including biologics and surgical interventions, offer new hope.
- Integrating psycho-social, nutritional, and palliative care is essential for holistic patient management.
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