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Suggest Treatment For Advanced COPD And Type II Respiratory Failure Symptoms
Question: Need advice on a 75 year old female patient who is a on a continuous bipap 14/6 and 2lpm oxygen support and duolin nebulization ( 4 times a day as prescribed by hospital). She is completely bed ridden at home and very often complains on shortness of breath, makes sound. She is very alert too as she interact with nurse.
Brief Answer:
She seems to be having advance COPD hence on continuous BiPAP.
Detailed Answer:
Hello XXXXXXX
Thanks for posting your query on HCM.
This lady seems to be having very advanced COPD with possibility of type II respirarory failure(No reports of blood gas analysis found attached). Hence she is on continuous BiPAP.
The line of treatment as seen in the attd file is on the standard line of management of such cases. You should follow the same as advised. Consult her physician for the duration defacort has to be given to her.
You have to be careful as she may develop problems associated with prolonged confinement to the bed like she may aspirate food or gastric content and develop pneumonia or she may develop hypostatic pneumonia. Some sort of chest physiotherapy and helping her cough to bring out accumulated secretions in between BiPAP may help.
Frequent changes of position is required to prevent bedsores. Can she be made ambulatory even for short period as this will help.
She seems to be on tube feeding hence look after her nourishment in consultation with a dietician or her treating physician.
I hope this answers your query.
Take care.
She seems to be having advance COPD hence on continuous BiPAP.
Detailed Answer:
Hello XXXXXXX
Thanks for posting your query on HCM.
This lady seems to be having very advanced COPD with possibility of type II respirarory failure(No reports of blood gas analysis found attached). Hence she is on continuous BiPAP.
The line of treatment as seen in the attd file is on the standard line of management of such cases. You should follow the same as advised. Consult her physician for the duration defacort has to be given to her.
You have to be careful as she may develop problems associated with prolonged confinement to the bed like she may aspirate food or gastric content and develop pneumonia or she may develop hypostatic pneumonia. Some sort of chest physiotherapy and helping her cough to bring out accumulated secretions in between BiPAP may help.
Frequent changes of position is required to prevent bedsores. Can she be made ambulatory even for short period as this will help.
She seems to be on tube feeding hence look after her nourishment in consultation with a dietician or her treating physician.
I hope this answers your query.
Take care.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi Doc,
Thanks for you valuable advice. I will certainly take care of these points that you mentioned.
For Shortness of Breath that she very often encounters, can you suggest some medication for quick relief.
what are the side effect of long term use of Duolin?
Do we have any treatment avaiable for advance COPD that you have mentioned. Doctor who treated in Hospital says, she is suffering from ILD (IPF).
Please suggest, if any kind of treatment is available.
Thank you.
Thanks for you valuable advice. I will certainly take care of these points that you mentioned.
For Shortness of Breath that she very often encounters, can you suggest some medication for quick relief.
what are the side effect of long term use of Duolin?
Do we have any treatment avaiable for advance COPD that you have mentioned. Doctor who treated in Hospital says, she is suffering from ILD (IPF).
Please suggest, if any kind of treatment is available.
Thank you.
Brief Answer:
Duolin nebulization or inhaler may be used for immediate relief.
Detailed Answer:
Duolin nebulization can be done for immediate relief of shortness of breath which she is already taking.
Duolin may affect in the long term.
I presumed she is suffering from COPD as this being a very common cause and I did not have any information on her diagnosis. ILD is another cause where BiPAP has to be used in advance stages.
For ILD there are antifibrotic agents available but they may not be very effective in advance stage. Long term oxygen therapy may also help.You may discuss it with her treating physician.
Duolin nebulization or inhaler may be used for immediate relief.
Detailed Answer:
Duolin nebulization can be done for immediate relief of shortness of breath which she is already taking.
Duolin may affect in the long term.
I presumed she is suffering from COPD as this being a very common cause and I did not have any information on her diagnosis. ILD is another cause where BiPAP has to be used in advance stages.
For ILD there are antifibrotic agents available but they may not be very effective in advance stage. Long term oxygen therapy may also help.You may discuss it with her treating physician.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
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