Objective To determine the efficacy and prognosis of noninvasive positive pressure ventilation (NPPV) in exacerbations of chronic obstructive pulmonary disease (COPD). Methods Trials were located through electronic searches of MEDLINE, EMBASE, Springer, and Foreign Journals Integration System (from the start date to March 2008). We also checked the bibliographies of retrieved articles. Statistical analysis was performed with The Cochrane Collaboration’s software RevMan 4.2.10. Results A total of 19 trials involving 1 236 patients were included. Results showed that: (1) NPPV vs. conventional therapy: NPPV was superior to conventional therapy in terms of intubation rate (RR 0.36, 95%CI 0.27 to 0.49), failure rate (RR 0.62, 95%CI 0.43 to 0.90), and mortality (RR 0.49, 95%CI 0.34 to 0.69). The length of hospital stay was shorter in the NPPV group compared with the conventional group (WMD – 3.83, 95%CI – 5.78 to – 1.89), but the length of ICU stay was similar. The changes of PaO2, PaCO2, and pH were much more obvious in the NPPV group compared with the conventional group. The change of respiratory rate was more significant in the NPPV group compared with the conventional group (WMD – 3.75, 95%CI – 5.48 to – 2.03). At discharge and follow-up, there were no significant differences in FEV1, pH, PaCO2, PaO2, and vital capacity between the two groups. (2) NPPV vs. invasive ventilation: the mortality was similar between the two groups. The incidence of complications was lower in the NPPV group compared with the invasive group (RR 0.38, 95%CI 0.20 to 0.73). The length of ICU stay, duration of mechanical ventilation, and weaning time were shorter in the NPPV group than those of the invasive group. At discharge and follow-up, clinical conditions were similar between the two groups. Conclusion The limited current evidence showed that NPPV was superior to conventional therapy in improving intubation rate, mortality, short term of blood-gas change, the change of respiratory rate; and superior to invasive ventilation in the length of hospital stay and the incidence of complication. There were no difference among them in discharge and follow-up.
ObjectiveTo investigate the current status of outpatient pain management in patients with pulmonary disease after surgery by WeChat and to provide a basis for postoperative pain management.MethodsA total of 449 patients who underwent thoracic surgery in our hospital from December 2017 to May 2018 were enrolled, including 156 males and 293 females with an average age of 22-83 (55.54±11.17) years. Brief Pain Inventory was adopted for pain assessment in 24-48 hours after discharge and 24 hours after removal of from the wound.ResultsTotally 98.22% of the patients reported that they suffered from pain in 24-48 h after discharge, most pain position was still at drainage port (45.21%), the overall pain score was 2.75 (2.00, 3.25) points, and 82.85% of patients adopted physical methods to relieve pain. After removal of stitches at the drainage port, 79.29% of the patients suffered from pain, the pain site was mainly at the drainage port (47.88%), and the overall pain score was 1.75 (1.25, 2.25) points, and 73.94% of patients adopted physical methods to relieve pain. The score of the overall influence degree of pain on patients was 2.29 (1.86, 2.86) points and 1.86 (1.29, 2.43) points, while pain had the greatest influence on sleep and mood. The scores were 4.00 (3.00, 5.00) points, 3.00 (2.00, 4.00) points and 2.00 (1.00, 4.00) points, 3.00 (2.00, 4.00) points, respectively.ConclusionUnder the concept of enhanced recovery after surgery, the overall pain level of patients with pulmonary disease after discharge is mild pain, but the application rate of drug analgesia in patients is low. The overall effect of pain on postoperative patients with lung cancer is low, but it has a great impact on sleep and mood. Medical staff should strengthen the pain education for patients in order to improve their pain self-management ability.
Electrical impedance tomography (EIT) is a new non-invasive functional imaging technology, which has the advantages of non-invasion, non-radiation, low cost, fast response, portability and visualization. In recent years, more and more studies have shown that EIT has great potential in the detection of lung diseases and has been applied to early diagnosis and treatment of some diseases. This paper introduced the basic principle of EIT, discussed the research and clinical application of EIT in the detection of acute respiratory distress syndrome, chronic obstructive pulmonary disease, pneumothorax and pulmonary embolism, and focused on the summary and introduction of indicators and functional images of EIT related to the detection of lung diseases. This review will help medical workers understand and use EIT, and promote the further development of EIT in lung diseases as well as other fields.
Due to their diverse types, complex causes, high incidence, and difficult treatment, lung diseases have become major killers threatening human life and health, and some lung diseases have a significant impact on alveolar morphology and histology. Numerical simulation of alveolar mechanical response, alveolar flow field information, multiphase flow, and material transport based on computational fluid dynamics is of great significance for lung disease diagnosis, clinical treatment, and in vitro experiments. Starting from the simplification and pathological differences of geometric and mechanical models, this paper analyzes and summarizes the conditions and application scenarios of the airflow dynamics calculation method in pulmonary alveoli, to provide a reference for further simulation and application of the alveolar region.
ObjectiveTo analyze the disease burden and temporal trends of chronic obstructive pulmonary disease (COPD) attributable to air pollution in China from 1990 to 2021. MethodsUtilizing data from the Global Burden of Disease Study 2021 (GBD 2021), we assessed the burden of COPD attributable to air pollution in China through metrics including death counts, disability-adjusted life years (DALYs), age-standardized mortality rate (ASMR), age-standardized DALY rate (ASDR), annual percentage change (APC), and average annual percentage change (AAPC). A Bayesian Age-Period-Cohort (BAPC) model was employed to project future trends in COPD burden attributable to air pollution. ResultsIn 2021, China’s ASMR and ASDR for COPD attributable to air pollution were 32.57 and 533.84 per 100 000 population, respectively, exceeding global averages. From 1990 to 2021, both ASMR and ASDR exhibited significant declining trends, with AAPCs of ?5.24% (95% CI ?5.78% to ?4.70%) and ?5.28% (95% CI ?5.75% to ?4.81%), respectively. The burden intensified with advancing age and was disproportionately higher among males compared to females. BAPC projections indicate a continued decline in COPD burden from 2022 to 2035, with ASMR expected to decrease from 56.40 to 23.02 per 100 000 and ASDR from 900.14 to 408.64 per 100 000. Conclusion Despite sustained reductions in the burden of COPD attributable to air pollution in China from 1990 to 2021, with further declines anticipated through 2035, national rates remain elevated relative to global benchmarks. Male and elderly populations bear the highest burden, underscoring the urgency for targeted interventions to mitigate air pollution exposure and address health disparities in vulnerable demographics.