Lovego Weekly Report-Long term oxygen therapy(LTOT)

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Long term oxygen therapy(LTOT)

Long term oxygen therapy(LTOT) refers to providing supplemental oxygen to the Chronic hypoxaemia patients( including Sleep and Motility hypoxemia), and lasting for a long time. Most of scholars agree that the time shall be at least 6 months. The standard long term oxygen therapy shall be 24 h/d, says continuously oxygen therapy. However, some patients are hard to finish it, so when breathing supplemental oxygen for above 18 hours everyday, we call continuously oxygen therapy. When taking 12 hours only at night(including sleeping) everyday, we call Night oxygen therapy.

To get a good effect of the oxygen therapy, the current consensus is taking  at least 15 hours supplemental oxygen and make the Pao2 reach 60mmHg.

So why shall we carry out the long term oxygen therapy ?

As along with the process of COPD, many patients are with the hypoxaemia conditions, and the PaO2 of most patients is decreasing by 1.33mmHg every year. The low hypoxaemia and hypercapnia will make the pulmonary muscularized arteries spasm and increase the resistance of the pulmonary circulation, then it will form the Pulmonary hypertension, finally leads to the heart disease. The spasm of pulmonary small artery is the main cause for the dramatic increase in pulmonary artery pressure when the chronic pulmonary patients are under acute exacerbation.

By improving the hypoxaemia, the pulmonary artery pressure can go down. It is good to the disease. If not, it will make the vessel narrow and fibrosis because of the continuously spasm and PAH. Also, as the quantity of the lung capillary bed decreases and the pulmonary circulation resistance increases, the pulmonary artery pressure will increase continuously, it’ll make the right heart work overload, finally resulting in heart failure.

Stop smoking, anti-infection, diastole bronchus are the some important methods to improve and control the symptoms, but LTOT is the main factor to effect the Cor pulmonale prognostic.

To those with severe hyoxemia (PaO2<60mmHg), there are many benefits by carrying out the LTOT:

Improve the survival rate

Prevent deterioration of pulmonary hypertension

Decrease the incidence of polycythemia

Improve the sleep quality

Increase the renal blood flow

Reduce the incidence of arrhythmia

We suggest that the patient shall carry out the LTOT with below two factors:

1.     The PaO2< 50mmHg or between 50~60mmHg when under rest state

2.     There is one of the following symptoms: secondary polycythemia/ Hypoxia at night/ Peripheral oedema/ Pulmonary hypertension.

Evaluation index for LTOT

Indications	Specific performance
Severe COPD Tissue hypoxia Right heart failure	FEV1<40% Labial surface cyanosis Polycythemia (Hematocrit increased) Confusion during acute infection arterial oxygen saturation < 92% arterial PaCo2> 50mmHg Peripheral oedema Jugular vein pressure increases fluid collection and gain the weight

To get a good effect, the time to breath supplemental oxygen shall be at least above 15 hours. The flow is between 1~3L/min to avoid inhibiting the respiration and the aggravating carbon dioxide retention

Email: service@oxygencare.cn Tel: 400 6677 247/075523733851

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Lovego weekly report-Pulmonary hypertension

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Pulmonary hypertension

Pulmonary hypertension (PH) is a a type of high blood pressure that affects the arteries in the lungs and the right side of our heart. It is a kind of extremely severe and risk disease. And the 75% of patients is in 20 ~ 40 years of age.

The PH begins when the tiny arteries in our lungs called pulmonary arteries, and capillaries become narrowed, blocked or destroyed. This makes it harder for blood to flow through the lungs, and raises pressure within our lungs' arteries. As the pressure builds, our heart's lower right chamber (right ventricle) must work harder to pump blood through the lungs, eventually causing the heart muscle to weaken and cannot do its job, eventually can develop heart failure.

There are many reasons can lead PH, like left-sided heart failure, congenital heart disease, Anoxic lesions, pulmonary thromboembolism, ect, The most topic we talked about before is the COPD, it causes the Anoxic lesions for lung and can cause the PH too. According to the report, these specific causes of pulmonary hypertension occupied the main body of the crowd, can even reach 99%.

The symptoms of PH include

• Shortness of breath during routine activity, such as climbing two flights of stairs 
• Fatigue 
• Chest pressure or pain 
• A racing heartbeat 
• Pain on the upper right side of the abdomen 
• Decreased appetite 
• Chest pressure or pain 

The pulmonary hypertension is devided into two kinds. One is Idiopathic pulmonary hypertension, when an underlying cause for high blood pressure in the lungs can't be found, the condition is called idiopathic pulmonary hypertension (IPH).Some are caused by genes, some are with unknow reason yet. And the other one is secondary pulmonary hypertension. The reasons we refered on above, they all belong to this kind. It is more common for the pulmonary hypertension

Many doctors hold the idea it is a uncurable disease, but it is too old thinking. Though there are no effective ways to treat it at present, the new treatment like gene therapy/ lung transplant/ Interatrial septum colostomy have been in application.

Email: service@oxygencare.cn Tel: 400 6677 247/075523733851

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Toll free: 400-6677-247

Tel:86-0755-23733851

Add: Building B, LC Hi-tech Park, Longhua District, Shenzhen, China

Lovego weekly report- COPD and Pneumonia

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COPD and Pneumonia

We introduced the definition of Pneumonia and the causes briefly last week. So

What’s the main treatment for it ?

How to prevent the disease?

What’s the link between Pneumonia and COPD ?

Let’s discuss step by step

1.     What’s the main treatment for it ?

The treatments depend on the type of the pneumonia and its severity.  Mild cases of pneumonia can usually be treated at home with antibiotics and plenty of rest and fluids. More severe cases may need hospital treatment.

Most important to keep in mind, we shall get plenty of rest and sleep and drink lots of fluids

2.     How to prevent the disease?

Bacteria or viruses usually cause pneumonia, we shall take the steps to kill them or stay away from them

l  The most common used way is the vaccinations. Children get the pneumococcal conjugate vaccine (PCV) as a routine vaccination. Older adults (age 65 or older), people who smoke, and people who have some long-term (chronic) conditions also need the pneumococcal vaccine. Depending on age and other things, adults can get PCV or the pneumococcal polysaccharide vaccine (PPSV). Some adults need both types

l  Wash your hands with soap and water or alcohol-based rubs to kill germs.

l  Stop smoking. Smoking damages our lungs' ability to filter out and defend against germs.

l  Stay away from people who have colds, the flu, or other respiratory tract infections.

3. What’s the link between Pneumonia and COPD ?

Pneumonia and COPD work as a sort of a vicious circle in that one can greatly impact the other, making symptoms more severe and dangerous for the patient. COPD and pneumonia are known risk factors for respiratory failure so when you combine the two it is especially serious. COPD exacerbations are easy to be caused by bacterial infections.

In later stage of COPD, the symptoms of worsening COPD or an exacerbation and pneumonia are often quite similar. So inform the doctor about any changes for the symptoms is very important.

Common symptoms in COPD, which get worse in later stages and during exacerbations include:

cough

shortness of breath

sputum production

wheezing

chest tightness

Pneumonia causes all of the same symptoms as listed above, but can also cause:

high fever

chills and shaking

chest pain when coughing or breathing

More common in COPD exacerbations and pneumonia is:

inability to speak due to a lack of air

change in color of your mucus that could be green, tan, yellow, or bloody

high fever

inability to get your usual relief from your COPD medication

Regardless of whether you are experiencing a COPD exacerbation or have developed pneumonia, getting medical treatment as quickly as possibly is key. The sooner you are able to receive treatment and get your symptoms under control, the less damage that pneumonia is able to cause your lungs which are already damaged from COPD.  This damage can include inflammation that further limits your airflow and causes irreversible damage to your lung tissue. The most serious complication of pneumonia is respiratory failure. And the acute respiratory failure is one of the leading causes of concerns when a COPD patient develops pneumonia.

Email: service@oxygencare.cn Tel: 400 6677 247/075523733851

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Toll free: 400-6677-247

Tel:86-0755-23733851

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Lovego weekly report-Pneumonia

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Weekly report

Pneumonia

In the following several weeks, we are going to introduce and share the information about Pneumonia and the link for Pneumonia &COPD. As we know, the people with COPD are known to be at a higher risk of pneumonia, it is necessary for us to know more about them. And this week, let’s introduce what is Pneumonia.

Pneumonia is a lung infection that can make you very sick. You may cough, run a fever, and have a hard time breathing. For most people, pneumonia can be treated at home. It often clears up in 2 to 3 weeks. But older adults, babies, and people with other diseases can become very ill. They may need to be in the hospital.

Germs called bacteria or viruses usually cause pneumonia.Pneumonia usually starts when you breathe the germs into your lungs. You may be more likely to get the disease after having a cold or the flu. These illnesses make it hard for your lungs to fight infection, so it is easier to get pneumonia. Having a long-term, or chronic, disease like asthma, heart disease, cancer, or diabetes also makes you more likely to get pneumonia.

Symptoms of pneumonia caused by bacteria usually come on quickly. They may include:

Cough. You will likely cough up mucus (sputum) from your lungs. Mucus may be rusty or green or tinged with blood.

Fever.

Fast breathing and feeling short of breath.

Shaking and "teeth-chattering" chills.

Chest pain that often feels worse when you cough or breathe in.

Fast heartbeat.

Feeling very tired or very weak.

Nausea and vomiting.

Diarrhea.

Symptoms caused by viruses are the same as those caused by bacteria. But they may come on slowly and often are not as obvious or as bad

Mainly, the pneumonia is devided into two kinds, community-associated pneumonia and healthcare-associated pneumonia. The former is the pneumonia you get in your daily life, such as at school or work. The later is the pneumonia getted when you are in a hospital or nursing home. It is usually caused by a bacterial infection, rather than a virus.

 Email: service@oxygencare.cn Tel: 400 6677 247/075523733851

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Toll free: 400-6677-247

Tel:86-0755-23733851

Add: Building B, LC Hi-tech Park, Longhua District, Shenzhen, China

Lovego weekly report-What’s the 6 minutes walk test(6MWT) ?

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What’s the 6 minutes walk test(6MWT) ?

6 minutes walk test, we call 6MWT. It is one of the most common used way to assess the exercise capacity for people who suffer from the COPD.

The test dates from the early 1960s, A 12-minute field performance test was then developed to evaluate the level of physical fitness of healthy individuals. The walking test was also adapted to assess disability in patients with chronic bronchitis. In an attempt to accommodate patients with respiratory disease for whom walking 12 minutes was too exhausting, a 6-minute walk was found to perform as well as the 12-minute walk. There are many existing tests to assess the patients’ functional status, such as the questionnaire survey or self-assessment, climbing stairs, bicycle exercise test,6MWT ect, among of them the 6MWT is easy to administer, better tolerated, and more reflective of activities of daily living than the other walk tests. Due to these, the 6MWT has got more and more attention.

While testing, the 6MWT requires a 100-ft hallway but no exercise equipment or advanced training for technicians. The test measures the distance of the patients quickly able to walk on a flat, hard surface within 6 minutes. It evaluates the global and integrated responses of all the systems involved during exercise, including the pulmonary and cardiovascular systems, systemic circulation, peripheral circulation, blood, neuromuscular units, and muscle metabolism. But as the test doesn’t reach the extremity for the cardiopulmonary exercise capacity, it can’t be applied to evaluate the accumulating capacity of cardio-pulmonary function.


Any Questions when you use LoveGo POC, kindly contact us

Email: service@oxygencare.cn Tel: 400 6677 247/075523733851

Lovego Service 

Toll free: 400-6677-247

Tel:86-0755-23733851

Add: Building B, LC Hi-tech Park, Longhua District, Shenzhen, China