COPD and Lung Health

Respiratory diseases encompass a variety of pathogenic conditions that affect respiration in living organisms. Respiration involves gas exchange in higher organisms. Respiratory disorders occur in the respiratory tract, which includes the alveoli, bronchi, bronchioles, pleura, pleural cavity, trachea and the nerves and muscles of breathing. Respiratory diseases or lung diseases include COPD, asthma, cystic fibrosis, emphysema, lung cancer, interstitial lung disease, mesothelioma, pulmonary hypertension, tuberculosis, alpha-1 antitrypsin deficiency, bronchiectasis, idiopathic pulmonary fibrosis, pneumonia, respiratory failure, respiratory distress syndrome, sarcoidosis, sleep apnea, sleep deprivation and deficiency, influenza and many more. If left untreated, they lead to health complications and life-threatening conditions.

COVID-19 is a respiratory disease which causes a range of breathing problems, from mild to critical. Older adults and people who have other health conditions like heart disease, cancer, and diabetes may have more serious symptoms when compared to others. Coronavirus can infect the upper or lower part of the respiratory tract and travels down the airways making the lining become irritated and inflamed. In some cases, the infection can reach all the way down into the alveoli. Respiratory inflammation can be observed on a chest X-ray or CT scan. Currently, convalescent plasma from a recovered patient is given by transfusion to a patient who is suffering from COVID-19. The donor antibodies may help the patient fight the illness, possibly shortening the reducing the severity of the disease.

Bronchoscopy is an endoscopic procedure of envisioning the inside of the air passages for diagnostic and therapeutic purposes. An instrument (bronchoscope) is inserted into the airways, consistently through the nose or mouth, or seldom through a tracheostomy. This allows the specialist to examine the patient's airways for abnormalities such as foreign bodies, bleeding, tumors, or inflammation. Specimens may be taken from inside the lungs. The construction of bronchoscopes ranges from rigid metal tubes with attached lighting devices to flexible optical fiber instruments with Real time video equipment.

Pulmonary Rehabilitation is an exclusive program for education and exercise that helps to manage the breathing problems, increase the alveolar capacity for breathing and the energy of the individual and reduces the breathlessness. Pulmonary rehabilitation can help to gain strength, reduce symptoms of anxiety or depression, and make it easier to manage routine activities, work, and outings or social activities.

Pediatric Pulmonology is a medical speciality of pediatrics that deals with the diagnosis and treatment of diseases involving respiratory tract and it is a combination of both pulmonology and paediatrics. Pediatric pulmonologists care for infants, children, and adolescents with chronic lung diseases, ventilatory muscle weakness, and disorders of neurologic control of breathing. The majority of pediatric respiratory illnesses are mild and has resolution on their own or respond to treatment given in primary care.

Pediatric pulmonology and Critical Care is accomplished to caring for critically ill patients and patients with lung diseases- asthma, pneumonia, wheezing, bronchitis, COPD, cystic fibrosis. The division of pediatric pulmonary and critical care is consisted of a team of outstanding clinicians, scientists, and scholars dedicated to improve the lives of patients with serious lung disease and those who are critically ill.

• Pediatric Allergy
• Sleep apnea
• Breathing Problems
• Pediatric Pulmonary Hypertension

Lung cancer is a condition that causes cells to divide in the lungs uncontrollably which leads to the growth of tumors that reduce a person's ability to breathe. Symptoms of lung cancer include appetite loss, changes to a person's voice, such as hoarseness, frequent chest infections, such as bronchitis or pneumonia, lingering cough that may start to get worse, shortness of breath, unexplained headaches, weight loss and wheezing. Early diagnosis of lung cancer can be lifesaving because lung cancer cells can travel to other areas of the body before a doctor detects them in the lungs. If metastasis has taken place, it makes treating the disease much more difficult. Treatment for lung cancer depends on its location and stage, as well as the overall health of the individual. Possible treatments include surgery, chemotherapy, radiation therapy and targeted therapy.

A lung transplant is a surgical procedure to replace a diseased lung with a healthy lung. It is used to improve the quality of life and prolong the lifespan in people affected with severe or advanced chronic lung cases. The surgery can be for one lung or for both. Lung transplants can be over on people of almost all ages from new born to adults up to age 65.

• Single Lung Transplant
• Double Lung Transplant
• Heart-Lung Transplant
• Bilateral Sequential Transplant

Non-invasive ventilation (NIV) is the delivery of oxygen (ventilation support) via a face mask and therefore eradicating the need of an endotracheal airway. NIV achieves comparative physiological benefits to conventional mechanical ventilation by decreasing the work of breathing and improving gas exchange. Research suggests that non-invasive ventilation after early extubation looks helpful in reducing the total days spent on invasive mechanical ventilation. The intervention is recognised as an adequate treatment for respiratory failure in chronic obstructive pulmonary disease, cardiogenic pulmonary oedema and other respiratory conditions without complications such as respiratory muscle weakness, upper airway trauma, ventilator-associated pneumonia, and sinusitis.

Pulmonary hypertension is a complex pathophysiologic condition in which several clinical realities increase pressure in the pulmonary rotation, precipitously injuring cardiopulmonary function and, if undressed, causing right ventricular failure. The major role of imaging is to establish the diagnosis of PH and classify the PH into one of the five groups. Imaging is also used in the quantification of volumes and function, which is necessary for prognosis, therapy, and assessing response to treatment.

Engaging chronic obstructive pulmonary disease (COPD) patients to actively engage in self-management has proven difficult. Digital health technology (DHT) promises to expedite a patient-centred care model for the management of COPD by empowering patients to self-manage adequately. The emerging approaches included digital-technology-enabled homecare programs, electronic records, big data analytics, and environment-monitoring applications. The digital health approaches of telemonitoring, telehealth and mHealth support the self-management, post-discharge care, and hospital-at-home strategy, with eventual effects on reducing acute COPD exacerbations and hospitalizations.

Interventional pulmonology (IP) uses basic invasive procedures to diagnose and treat lung cancer, pleural diseases, and many types of complex airway and lung disorders.

Techniques for interventional pulmonology include:

• Flexible bronchoscopy
• Bronchoalveolar lavage
• Biopsy of lung or lymph node
• Airway stent (bronchial stent)
• Balloon bronchoplasty
• Rigid bronchoscopy
• Foreign body removal
• Pleuroscopy
• Thoracentesis

Interstitial lung disease characterizes a large group of disorders, most of which cause progressive scarring of lung tissue. The scarring correlated with interstitial lung disease basically affects your ability to breathe and get enough oxygen into your bloodstream. Interstitial lung disease can be induced by long-term exposure to hazardous materials, such as asbestos. Some types of autoimmune diseases, such as rheumatoid arthritis, also can cause interstitial lung disease.

Types of Interstitial lung disease:

• Interstitial pneumonia
• Idiopathic pulmonary fibrosis
• Hypersensitivity pneumonitis
• Asbestosis

Tuberculosis (TB) is a serious infectious disease that mainly affects the lungs and it is caused by bacteria (Mycobacterium tuberculosis). The bacterium responsible for tuberculosis is spread from one person to another through tiny droplets released into the air via cough and sneeze. Tuberculosis can be fatal when it is untreated. Untreated active disease typically affects the lungs, and it can spread to other parts of the body through the blood stream. Complications of tuberculosis include spinal pain, joint damage, swelling of the membranes that cover the brain, liver or kidney problems and heart disorders. People diagnosed with active TB disease generally have to take a combination of medications for six to nine months. A significant number of TB patients develop post tubercular airway disease or TB-associated COPD.

Asthma is a clinical syndrome of chronic airway inflammation characterized by recurrent and reversible airway obstruction. Most people with asthma will not develop COPD; however, it’s possible to have both. Asthma-COPD overlap syndrome (ACOS) occurs when someone has these two diseases at a time. Signs of ACOS include difficulty in breathing, wheezing, frequent coughing, excess phlegm, feeling tired, low physical tolerance for exercise, shortness of breath during routine activities. Common triggers for asthmatic symptoms include exposure to allergens (dust mites, cockroach, molds and pollens), exercise and viral infections. Most people who have asthma are treated with daily medicine, called long-term control medicines, along with inhalers containing medicine for short-term relief.

Pneumonia is an infection that inflames the air sacs in the lungs and people with COPD are more likely to develop pneumonia. It is most serious for infants, young children and older people whose age is above 65 and people with weakened immune systems. Bacterial pneumonia, is the most common form, tends to be more serious than other types of pneumonia. The symptoms of bacterial pneumonia can develop gradually. In few cases pneumonia can be difficult to diagnose because the symptoms are so variable and are often very similar to those seen in a cold or influenza. Complications of pneumonia are as follows: pleural effusion, empyema, lung abscess, bacteremia, septicemia, meningitis, septic arthritis, endocarditis, or pericarditis.

Sleep apnea is a sleep disorder that occurs when a person's breathing is interrupted during sleep. If left untreated, sleep apnea can increase the risk of health problems, such as high blood pressure, stroke, heart failure, irregular heartbeats, and heart attacks, diabetes, depression, worsening of ADHD, headaches. Depending on the cause and the level of apnea, there are different methods of treatment and the goal of treatment is to normalize breathing during sleep. Treatment options for obstructive sleep apnea include: Continuous Positive Airflow Pressure (CPAP), other breathing devices, oral appliances, implants and surgery.

Cystic fibrosis is a progressive, genetic disease that causes persistent lung infections and limits the ability to breathe over time and it affects the cells that produce mucus, sweat and digestive juices. It is caused by a change, or mutation, in a gene called CFTR (cystic fibrosis trans membrane conductance regulator). This gene controls the flow of salt and fluids in and out of the cells. The thick and sticky mucus associated with cystic fibrosis clogs the tubes that carry air in and out of the lungs. This can cause signs and symptoms such as persistent cough that produces thick mucus, wheezing, breathlessness, exercise intolerance, repeated lung infections, inflamed nasal passages or a stuffy nose. Cystic fibrosis is one of the leading causes of bronchiectasis, a condition that damages the airways and this makes it harder to move air in and out of the lungs and clear mucus from the airways.

Alpha-1 antitrypsin deficiency is a genetic disorder that is passed on in families and affects the lungs, liver and skin. When this condition affects the lungs, it causes COPD. There is no cure, but treatment can help people with Alpha-1 antitrypsin deficiency manage their symptoms and live a better life. The preliminary symptoms are shortness of breath following mild activity, reduced ability to exercise, and wheezing. Other signs and symptoms include unintentional weight loss, recurring respiratory infections, fatigue, and rapid heartbeat upon standing. Affected individuals often develop emphysema, which is a lung disease caused by damage to the small air sacs in the lungs. Alpha-1 antitrypsin deficiency accounts for 1 to 2% of all cases of chronic obstructive pulmonary disease.

Chronic Obstructive Pulmonary Disease (COPD) and Asthma are especially vulnerable to the obviously harmful effects of air pollutants. Air pollution can cause the increase of COPD and onset of asthma, increase the respiratory morbidity and mortality.

Air pollutants such as materials from the fuel combustion can cause inflammation in lungs and further impaired the decreased pulmonary function in COPD patients.

People especially those with COPD or asthma should be aware of the air quality and take excess measures.

Self-Management arrangement in COPD includes quitting smoking, improving exercise and physical activity levels, proper nutrition, and medication adherence. It is concentrating on a system for the exacerbation, and enhanced communication between the patient and health care providers make good clinical sense. It is deliberated an integral component of chronic care model of disease management which involves health care organization, community resources, delivery system redesign, and clinical information systems.

It helps the patient to acquire knowledge and skills required to follow the medical therapies. An efficient review of self-management in COPD concluded that it reduces hospital admissions and has no adverse effects.

Prevention of COPD

Primary Prevention: Avoid exposure, Help fight for clean air, never start smoking or quit smoking, reduce your exposure to COPD causing irritants

Secondary Prevention: Vaccination and Physical activity

The main test for diagnosing COPD is a lung function test called spirometry which involves the use of a machine called a spirometer that measures how much air you are able to move by taking a deep breath in and out, and how quickly you are able to do so. Arterial blood gas analysis is second important test in diagnosing COPD. This test measures how much oxygen and carbon dioxide are present in the blood. A high percentage of carbon dioxide in the blood can be a sign of poorly functioning lungs. The important methods of treatment are pharmacotherapy and smoking cessation, while pulmonary rehabilitation, long-term oxygen therapy, and surgery may be considered in selected patients. Steroids, inhalers and antibiotics may be prescribed to treat various symptoms of COPD. Smoking cessation is the most effective intervention in stopping the progression of COPD, as well as increasing survival rate of persons suffering with COPD. Hence, smoking cessation should be the top priority in the treatment of COPD.