American Journal of Internal Medicine

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A Review of the Non Pharmacologic Management of Chronic Obstructive Pulmonary Disease

Received: 24 December 2016    Accepted: 07 January 2017    Published: 01 February 2017
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Abstract

Over the years, the management of chronic obstructive pulmonary disease has evolved, but given the high mortality and morbidity of COPD, much work still needs to be done. To date, none of the existing pharmacological therapies for COPD has been shown conclusively to modify the long-term decline in lung function. Several trials have been completed to evaluate options that can improve patient symptoms and quality of life. Optimal management of COPD requires both pharmacologic and non-pharmacologic interventions. Some of the non-pharmacologic options for the management of COPD like Oxygen therapy have proven reduction in mortality and mortality, and an improvement in the quality of life. Lung transplant is the only treatment that can stop the decline in lung function. Smoking cessation is the non-pharmacologic intervention with the greatest capacity to influence the natural course of COPD. Pulmonary rehabilitation programs are evidence based, multidisciplinary and comprehensive interventions for patients with COPD. These programs involve patient assessment, exercise training, education, nutrition and psychosocial support. Pulmonary rehabilitation programs are designed to reduce symptoms, optimize functional status, increase participation and reduce health care cost through stabilizing or reversing systemic manifestations of the disease. This article discusses the most used non pharmacologic management of COPD and their usefulness in relieving symptoms and improving the quality of life for patients with severe COPD. These treatment options are used in addition to optimal pharmacologic therapy.

DOI 10.11648/j.ajim.20160406.18
Published in American Journal of Internal Medicine (Volume 4, Issue 6, November 2016)
Page(s) 131-147
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Smoking Cessation, Pulmonary Rehabilitation, Oxygen, Noninvasive Mechanical Ventilation, Lung Surgical Intervention

References
[1] Akwe, Joyce and Fair, Nadene, Chronic Obstructive Pulmonary Disease: An Overview of Epidemiology, Pathophysiology, Diagnosis, Staging and Management (March 31, 2016). International Journal of Clinical and Experimental Medical Sciences. 2016; 2 (2): 13-25. Available at SSRN: http://ssrn.com/abstract=2765281.
[2] Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global strategy for the diagnosis, management, and prevention of COPD. GOLD 2016. Accessed October 3, 2016.
[3] Friedman M, Hilleman DE. Economic burden of chronic obstructive pulmonary disease. Impact of new treatment options. Pharmacoeconomics. 2001; 19: 245–254.
[4] Miratvilles M, Murio C, Guerrero T, Gisbert R, on behalf of the DAFNE Study Group. Cost of chronic bronchitis and COPD. A 1-year follow-up study. Chest.2003; 123: 784–791.
[5] Faulkner MA, Hilleman DE. The economic impact of chronic obstructive pulmonary disease. Expert Opin Pharmacother. 2002; 3: 219–228.
[6] Rabe KF, Hurd S, Anzueto A, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. GOLD executive summary. Am J Respir Crit Care Med 2007; 176: 532–555.
[7] Calverley PM. Reducing the frequency and severity of exacerbations of chronic obstructive pulmonary disease. Proc Am Thorac Soc. 2004; 1: 121–4.
[8] Kanner RE, Connett JE, Williams DE, Buist AS. Effects of randomized assignment to a smoking cessation intervention and changes in smoking habits on respiratory symptoms in smokers with early chronic obstructive pulmonary disease: the Lung Health Study. Am J Med. 1999; 106: 410–6.
[9] Anthonisen NR, Skeans MA, Wise RA, Manfreda J, Kanner RE, Connett JE. The effects of a smoking cessation intervention on 14.5-year mortality: a randomized clinical trial. Ann Intern Med. 2005; 142: 233–9.
[10] Faulkner MA, Lenz TL, Stading JA. Cost-effectiveness of smoking cessation and the implications for COPD. Int J Chron Obstruct Pulmon Dis. 2006; 1: 279–87.
[11] Hoogendoorn M, Welsing P, Rutten-van Molken MP. Cost-effectiveness of varenicline compared with bupropion, NRT, and nortriptyline for smoking cessation in the Netherlands. Curr Med Res Opin. 2008; 24: 51–61.
[12] Johansson PM, Tillgren PE, Guldbrandsson KA, Lindholm LA. A model for cost-effectiveness analyses of smoking cessation interventions applied to a Quit-and-Win contest for mothers of small children. Scand J Public Health. 2005; 33: 343–52.
[13] Tsevat J. Impact and cost-effectiveness of smoking interventions. Am J Med. 1992; 93: 43S–7S.
[14] Stead LF, Koilpillai P, Fanshawe TR, Lancaster T. Combined pharmacotherapy and behavioural interventions for smoking cessation. Cochrane Database Syst Rev. 2016 Mar 24; 3: CD008286. doi: 10.1002/14651858.
[15] U. S. Preventive Services Task Force. Tobacco Smoking Cessation in Adults, Including Pregnant Women: Behavioral and Pharmacotherapy Interventions. September 2015. http: //www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/tobacco-use-in-adults-and-pregnant-women-counseling-and-interventions.
[16] Cahill K, Stevens S, Perera R, Lancaster T. Pharmacological interventions for smoking cessation: an overview and network meta-analysis. Cochrane Database Syst Rev. 2013; 31 (5): CD009329. doi: 10.1002/14651858.
[17] Hays JT, McFadden DD, Ebbert JO. Pharmacologic agents for tobacco dependence treatment: 2011 update. Curr Atheroscler Rep. 2012 Feb; 14 (1): 85-92.
[18] Waschki BKA, Holz O, Muller KC, Meyer T, Watz H, Magnussen H. Physical activity is the strongest predictor of all-cause mortality in patients with chronic obstructive pulmonary disease: a prospective cohort study. Chest. 2011; 140: 331–342.
[19] McCarthy B, Casey D, Devane D, Murphy K, Murphy E, Lacasse Y. Pulmonary rehabilitation for chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews 2015; Issue 2. Art. No.: CD003793. DOI: 10.1002/14651858.
[20] Mulhall P, Criner G. Non-pharmacological treatments for COPD. Respirology. 2016; 21: 791-809.
[21] Incorvaia C, Russo A, Foresi A, Berra D, Elia R, Passalacqua G. Effects of pulmonary rehabilitation on lung function in chronic obstructive pulmonary disease: the FIRST study. Eur J Phys Rehabil Med. 2014; 50: 419–26.
[22] Nici L, Raskin J, Rochester CL, Bourbeau JC, Carlin BW, Casaburi R, Celli BR, Cote C, Crouch RH, Diez-Morales LF, Donner CF. Pulmonary rehabilitation: what we know and what we need to know. Journal of Cardiopulmonary Rehabilitation and Prevention. 2009 May 1; 29 (3): 141-51.
[23] Gimenez M, Servera E, Vergara P, Bach JR, Polu JM. Endurance training in patients with chronic obstructive pulmonary disease: a comparison of high versus moderate intensity. Archives of physical medicine and rehabilitation. 2000 Jan 31; 81 (1): 102-9.
[24] L?tters, F., Van Tol, B., Kwakkel, G., and Gosselink, R. Effects of controlled inspiratory muscle training in patients with COPD: a meta-analysis. European Respiratory Journal. 2002; 20 (3): 570-577.
[25] Roberts CM, Lowe D, Bucknall CE, Ryland I, Kelly Y, Pearson MG. Clinical audit indicators of outcome following admission to hospital with acute exacerbation of chronic obstructive pulmonary disease. Thorax. 2002 Feb 1; 57 (2): 137-41.
[26] SEEMUNGAL TA, Donaldson GC, BHOWMIK A, JEFFRIES DJ, WEDZICHA JA. Time course and recovery of exacerbations in patients with chronic obstructive pulmonary disease. American journal of respiratory and critical care medicine. 2000 May 1; 161 (5): 1608-13.
[27] Agustí A. Systemic effects of chronic obstructive pulmonary disease: what we know and what we don't know (but should). Proceedings of the American Thoracic Society. 2007 Oct 1; 4 (7): 522-5.
[28] Swallow EB, Reyes D, Hopkinson NS, Man WD, Porcher R, Cetti EJ, Moore AJ, Moxham J, Polkey MI. Quadriceps strength predicts mortality in patients with moderate to severe chronic obstructive pulmonary disease. Thorax. 2007 Feb 1; 62 (2): 115-20.
[29] Soler X, Gaio E, Powell FL, Ramsdell JW, Loredo JS, Malhotra A, Ries AL. High prevalence of obstructive sleep apnea in patients with moderate to severe chronic obstructive pulmonary disease. Annals of the American Thoracic Society. 2015 Aug; 12 (8): 1219-25.
[30] Desveaux L, Janaudis-Ferreira T, Goldstein R, Brooks D. An international comparison of pulmonary rehabilitation: a systematic review. COPD: Journal of Chronic Obstructive Pulmonary Disease. 2015 Mar 4; 12 (2): 144-53.
[31] Garvey C, Bayles MP, Hamm LF, Hill K, Holland A, Limberg TM, Spruit MA. Pulmonary Rehabilitation Exercise Prescription in Chronic Obstructive Pulmonary Disease: Review of Selected Guidelines: AN OFFICIAL STATEMENT FROM THE AMERICAN ASSOCIATION OF CARDIOVASCULAR AND PULMONARY REHABILITATION. Journal of cardiopulmonary rehabilitation and prevention. 2016 Mar 1; 36 (2): 75-83.
[32] Solway S, Brooks D, Lau L, Goldstein R. The short-term effect of a rollator on functional exercise capacity among individuals with severe COPD. CHEST Journal. 2002 Jul 1; 122 (1): 56-65.
[33] Coquart JB, Grosbois JM, Olivier C, Bart F, Castres I, Wallaert B. home-based neuromuscular electrical stimulation improves exercise tolerance and health-related quality of life in patients with COPD. International Journal of Chronic Obstructive Pulmonary Disease. 2016; 11: 1189.
[34] Stoller JK, Panos RJ, Krachman S, et al. Oxygen therapy for patients with COPD: current evidence and the long-term oxygen treatment trial. Chest. 2010; 138: 179-187.
[35] Austin MA, Wills KE, Blizzard L, et al. Effect of high flow oxygen on mortality in chronic obstructive pulmonary disease patients in prehospital setting: randomised controlled trial. BMJ. 2010; 341: c5462. doi: http: //dx.doi.org/10.1136/bmj.c5462.
[36] Mitrouska I, Tzanakis N, Siafakas NM. Oxygen therapy in chronic obstructive pulmonary disease. In: SiafakasNM, ed. Management of Chronic Obstructive Pulmonary Diease. Eur Respir. 2006; 38: 302–312.
[37] Tarpy SP, Celli BR. Long-term oxygen therapy. N Engl J Med. 1995; 333: 710–714.
[38] Eaton T, Lewis C, Young P, et al. Long-term oxygen therapy improves health-related quality of life. Respir Med. 2004; 98: 285-293.
[39] Borak J, Sliwiński P, Tobiasz M, et al. Psychological status of COPD patients before and after one year of long-term oxygen therapy. Monaldi Arch Chest Dis. 1996; 51: 7-40
[40] Okubadejo AA, Paul EA, Jones PW, Wedzicha JA. Does long-term oxygen therapy affect quality of life in patients with chronic obstructive pulmonary disease and severe hypoxaemia? Eur Respir J. 1996; 9: 2335-2339.
[41] Ringbaek TJ, Viskum K, Lange P. Does long-term oxygen therapy reduce hospitalisation in hypoxaemic chronic obstructive pulmonary disease? Eur Respir J. 2002; 20: 38-42.
[42] Haidl P, Clement C, Wiese C, et al. Long-term oxygen therapy stops the natural decline of endurance in COPD patients with reversible hypercapnia. Respiration. 2004; 71: 342-347.
[43] Tanni SE, Vale SA, Lopes PS, et al. Influence of the oxygen delivery system on the quality of life of patients with chronic hypoxemia. J Bras Pneumol. 2007; 33: 161-167.
[44] Yamamoto H, Teramoto S, Yamaguchi Y, et al. Long-term oxygen administration reduces plasma adrenomedullin levels in patients with obstructive sleep apnea syndrome. Sleep Med. 2007; 9: 80-87.
[45] Snider GL. Enhancement of exercise performance in COPD patients by hyperoxia: a call for research. Chest. 2002; 122: 1830-1836.
[46] Somfay A, Porszasz J, Lee SM, Casaburi R. Dose-response effect of oxygen on hyperinflation and exercise endurance in nonhypoxaemic COPD patients. European Respiratory Journal. 2001; 18 (1): 77-84.
[47] Emtner M, Porszasz J, Burns M, et al. Benefits of supplemental oxygen in exercise training in nonhypoxemic chronic obstructive pulmonary disease patients. Am J Respir Crit Care Med. 2003; 168: 1034-1042.
[48] O’Donnell DE, D’Arisigny C, Webb KA. Effects of hyperoxia on ventilatory limitation during exercise in advanced chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2001; 163: 892–898.
[49] LaCasse Y, Lecours R, Pelletier C, Begin R, Maltais F. Randomised trial of ambulatory oxygen in oxygen-dependent COPD. Eur Respir J 2005; 25: 1032–1038.
[50] Ram FS, Wedzicha JA. Ambulatory oxygen for chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2002; 2: CD000238.
[51] Snider GL. Enhancement of exercise performance in COPD patients by hyperoxia: a call for research. Chest 2002; 122: 1830-1836.
[52] Budhiraja R, Siddiqi TA, Quan SF. Sleep disorders in chronic obstructive pulmonary disease: etiology, impact, and management. J Clin Sleep Med. 2015; 11: 259.
[53] Croxton TL, Bailey WC. Long-term oxygen treatment in chronic obstructive pulmonary disease: recommendations for future research: an NHLBI workshop report. Am J Respir Crit Care Med. 2006; 174: 373-378.
[54] Amani H, Lozano DD, Blome-Eberwein S. Brother, have you got a light? Assessing the need for intubation in patients sustaining burn injury secondary to home oxygen therapy. J Burn Care Res. 2012; 33: e280-e285.
[55] Murabit A, Tredget EE. Review of burn injuries secondary to home oxygen. J Burn Care Res. 2012; 33: 212-217.
[56] Sharma G, Meena R, Goodwin JS, et al. Burn injury associated with home oxygen use in patients with chronic obstructive pulmonary disease. Mayo Clin Proc. 2015; 90: 492-499.
[57] Carlos WG, Baker MS, McPherson KA, et al. Smoking-Related Home Oxygen Burn Injuries: Continued Cause for Alarm. Respiration. 2016; 91: 151-155.
[58] Sj?berg F, Singer M. The medical use of oxygen: a time for critical reappraisal. J Intern Med. 2013; 274: 505-528.
[59] Brochard L, Mancebo J, Wysocki M, et al. Noninvasive ventilation for acute exacerbations of chronic obstructive pulmonary disease. N Engl J Med. 1995; 333: 817-822.
[60] Ram FS, Picot J, Lightowler J, Wedzicha JA. Non-invasive positive pressure ventilation for treatment of respiratory failure due to exacerbations of chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2004; CD004104.
[61] Keenan SP, Sinuff T, Cook DJ, Hill NS. Which patients with acute exacerbation of chronic obstructive pulmonary disease benefit from noninvasive positive-pressure ventilation? A systematic review of the literature. Ann Intern Med. 2003; 138: 861-870.
[62] Williams JW, Cox CE, Hargett CW, et al. Noninvasive Positive-Pressure Ventilation (NPPV) for Acute Respiratory Failure. Agency for Healthcare Research and Quality; Rockville, MD: 2012. Available at: Http: //www.ncbi.nlm.nih.gov/pubmedhealth/PMH0047897/. Accessed September 12, 2016.
[63] Lindenauer PK, Stefan MS, Shieh MS, et al. Outcomes associated with invasive and noninvasive ventilation among patients hospitalized with exacerbations of chronic obstructive pulmonary disease. JAMA Intern Med. 2014; 174: 1982-1993.
[64] Keenan SP, Powers CE, McCormack DG. Noninvasive positive-pressure ventilation in patients with milder chronic obstructive pulmonary disease exacerbations: a randomized controlled trial. Respir Care. 2005; 50: 610-616.
[65] Conti G, Antonelli M, Navalesi P, et al. Noninvasive vs. conventional mechanical ventilation in patients with chronic obstructive pulmonary disease after failure of medical treatment in the ward: a randomized trial. Intensive Care Med. 2002; 28: 1701-1707.
[66] Martin TJ, Hovis JD, Costantino JP, et al. A randomized, prospective evaluation of noninvasive ventilation for acute respiratory failure. Am J Respir Crit Care Med. 2000; 161: 807-813.
[67] Plant PK, Owen JL, Elliott MW. Early use of non-invasive ventilation for acute exacerbations of chronic obstructive pulmonary disease on general respiratory wards: A multicentre randomized controlled trial. Lancet. 2000; 355: 1931-1935.
[68] Non-invasive ventilation in acute exacerbations of chronic obstructive pulmonary disease: Long term survival and predictors of in-hospital outcome. Thorax. 2001; 56: 708-712.
[69] Conti G, Antonelli M, Navalesi P, et al. Noninvaisve vs. conventional mechanical ventilation in patients with chronic ob?structive pulmonary disease after failure of medical treatment in the ward: A randomized trial. Intensive Care Med. 2002; 28: 1701-1707.
[70] Kwok H, McCormack J, Cece R, et al. Controlled trial of oronasal versus nasal mask ventilation in the treatment of acute respiratory failure. Crit Care Med. 2003; 31: 468-473.
[71] Safka KA, McIvor RA. Non-Pharmacological Management of Chronic Obstructive Pulmonary Disease. The Ulster Medical Journal. 2015; 84 (1): 13-21.
[72] Schettino G, Altobelli N, Kacmarek RM. Noninvasive positive pressure ventilation reverses acute respiratory failure in select “do-not-intubate” patients. Crit Care Med. 2005; 33: 1976-1982.
[73] Diaz O, Iglesia R, Ferrer M, et al. Effects of noninvasive ventilation on pulmonary gas exchange and hemodynamics during acute hypercapnic exacerbations of chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 1997; 156: 1840-1845.
[74] Struik FM, Sprooten RT, Kerstiens HA, Bladder G, Zinjen M, Asin J. Nocturnal non-invasive ventilation in COPD patients with prolonged hypercapnia after ventilatory support for acute respiratory failure: a randomised, controlled, parallel-group study. Thorax. 2014; 69 (9): 826–34.
[75] Marin JM, Soriano JB, Carrizo SJ, Boldova A, Celli BR. Outcomes in patients with chronic obstructive pulmonary disease and obstructive sleep apnea: the overlap syndrome. Am J Respir Crit Care Med. 2010; 182(3): 325–31.
[76] Ambrosino N, Strambi S. New strategies to improve exercise tolerance in chronic obstructive pulmonary disease. Eur Respir J. 2004; 24: 313–322.
[77] Ambrosino N. Assisted ventilation as an aid to exercise training: a mechanical doping? Eur Respir J. 2006; 27: 3–5.
[78] Maltais F, Reissmann H, Gottfried SB. Pressure support reduces inspiratory effort and dyspnea during exercise in chronic airflow obstruction. Am J Respir Crit Care Med. 1995; 151: 1027–1033.
[79] Polkey MI, Kyroussis D, Mills GH, et al. Inspiratory pressure support reduces slowing of inspiratory muscle relaxation rate during exhaustive treadmill walking in severe COPD. Am J Respir Crit Care Med. 1996; 154: 1146–1150.
[80] Kyroussis D, Polkey MI, Hamnegard CH, Mills GH, Green M, Moxham J. Respiratory muscle activity in patients with COPD walking to exhaustion with and without pressure support. Eur Respir J. 2000; 15: 649–655.
[81] Polkey MI, Hawkins P, Kyroussis D, Ellum SG, Sherwood R, Moxham J. Inspiratory pressure support prolongs exercise induced lactataemia in severeCOPD. Thorax. 2000; 55: 547–549.
[82] Keilty SE, Ponte J, Fleming TA, Moxham J. Effect of nspiratory pressure support on exercise tolerance and breathlessness in patients with severe stable chronic obstructive pulmonary disease. Thorax. 1994; 49: 990–994.
[83] Bianchi L, Foglio K, Pagani M, Vitacca M, Rossi A, Ambrosino N. Effects of proportional assist ventilation on exercise tolerance in COPD patients with chronic hypercapnia. Eur Respir J. 1998; 11: 422–427.
[84] Johnson JE, Gavin DJ, Adams-Dramiga S. Effects of training with heliox and noninvasive positive pressure ventilation on exercise ability in patients with severe COPD. Chest. 2002; 122: 464–472.
[85] Van ’t Hul A, Kwakkel G, Gosselink R. The acute effects of noninvasive ventilatory support during exercise on exercise endurance and dyspnea in patients with chronic obstructive pulmonary disease: a systematic review. J Cardiopulm Rehabil 2002; 22: 290–297.
[86] Costes F, Agresti A, Court-Fortune I, Roche F, Vergnon J, Barthelemy JC. Noninvasive ventilation during exercise training improves exercise tolerance in patients with chronic obstructive pulmonary disease. J Cardiopulm Rehabil. 2003; 23: 307–313.
[87] Van ’t Hul A, Gosselink R, Hollander P, Postmus P, Kwakkel G. Acute effects of inspiratory pressure support during exercise in patients with COPD. Eur Respir J. 2004; 23: 34–40.
[88] Van ’t Hul A, Gosselink R, Hollander P, Postmus P, Kwakkel G. Training with inspiratory pressure support in patients with severe COPD. Eur Respir J. 2006; 27: 65–72.
[89] Levy M, Tanios MA, Nelson D, et al. Outcomes of patients with do-not-intubate orders treated with noninvasive ventilation. Crit Care Med. 2004; 32: 2002–2007.
[90] Schettino G, Altobelli N, Kacmarek RM. Noninvasive positive pressure ventilation reverses acute respiratory failure in selected ‘‘do-not-intubate’’ patients. Crit Care Med. 2005; 33: 1976–1982.
[91] Chu C-M, Chan VL, Wong IWY, Leung W, Lin AWN, Cheung K-F. Noninvasive ventilation in patients with acute hypercapnic exacerbation of chronic obstructive pulmonary disease who refused endotracheal intubation. Crit Care Med. 2004; 32: 372–377.
[92] Nava S, Sturani C, Hartl S, et al. End-of-life decisionmaking in respiratory intermediate care units: a European survey. Eur Respir J. 2007; 30: 156–164.
[93] Curtis JR, Cook DJ, Sinuff T, et al. Noninvasive positive pressure ventilation in critical and palliative care settings: understanding the goals of therapy. Crit Care Med. 2007; 35: 932–939.
[94] Meyers BF, Patterson GA. Chronic obstructive pulmonary disease ? 10: Bullectomy, lung volume reduction surgery, and transplantation for patients with chronic obstructive pulmonary disease. Thorax. 2003; 58: 7 634-638 doi: 10.1136/thorax.58.7.634
[95] Palla A, Desideri M, Rossi G, et al. Elective surgery for giant bullous emphysema: a 5-year clinical and functional follow-up. Chest. 2005; 128: 2043-2050.
[96] Neviere R, Catto M, Bautin N, et al. Longitudinal changes in hyperinflation parameters and exercise capacity after giant bullous emphysema surgery. J Thorac Cardiovasc Surg. 2006; 132: 1203-2307.
[97] Greenberg JA, Singhal S, Kaiser LR. Giant bullous lung disease: evaluation, selection, techniques, and outcomes. Chest Surg Clin N Am. 2003; 13: 631-649.
[98] Lederer DJ, Arcasoy SM. Update in surgical therapy for chronic obstructive pulmonary disease. Clin Chest Med. 2007; 28: 639–653.
[99] Clarenbach CF, Sievi NA, Brock M, et al. Lung Volume Reduction Surgery and Improvement of Endothelial Function and Blood Pressure in Patients with Chronic Obstructive Pulmonary Disease. A Randomized Controlled Trial. Am J Respir Crit Care Med. 2015; 192: 307-314.
[100] Lando Y, Boiselle PM, Shade D, Furukawa S, Kuzma AM, Travaline JM, Criner GJ. Effect of lung volume reduction surgery on diaphragm length in severe chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 1999; 159: 796–805.
[101] Bellemare F, Cordeau MP, Couture J, Lafontaine E, Leblanc P, Passerini L. Effects of emphysema and lung volume reduction surgery on transdiaphragmatic pressure and diaphragm length. Chest. 2002; 121: 1898–1910.
[102] Scott JP, Gillespie DJ, Peters SG, Beck KC, Midthun DE, McDougall JC, Daly RC, McGregor CG. Reduced work of breathing after single lung transplantation for emphysema. J Heart Lung Transplant. 1995; 14: 39–43.
[103] Brath H, Lahrmann H, Wanke T, Wisser W, Wild M, Schlechta B, Zwick H, Klepetko W, Burghuber OC. The effect of lung transplantation on the neural drive to the diaphragm in patients with severe COPD. Eur Respir J. 1997; 10: 424–429.
[104] Martinez FJ, de Oca MM, Whyte RI, Stetz J, Gay SE, Celli BR. Lung-volume reduction improves dyspnea, dynamic hyperinflation, and respiratory muscle function. Am J Respir Crit Care Med. 1997; 155: 1984–1990.
[105] National Emphysema Treatment Trial Research Group. A randomized trial comparing lung volume reduction surgery with medical therapy for severe emphysema. N Engl J Med. 2003; 348: 2059–2073.
[106] Naunheim KS, Wood DE, Mohsenifar Z, Sternberg AL, Criner GJ, DeCamp MM, Deschamps CC, Martinez FJ, Sciurba FC, Tonascia J, et al.; National Emphysema Treatment Trial Research Group. Long-term follow-up of patients receiving lung-volume-reduction surgery versus medical therapy for severe emphysema by the National Emphysema Treatment Trial Research Group. Ann Thorac Surg. 2006; 82: 431–443.
[107] Krachman SL, Chatila S, Martin UJ, Nugent T, Crocetti J, Ghaughan J, Criner GJ. Effects of lung volume reduction surgery on sleep quality and nocturnal gas exchange in patients with severe emphysema. Chest. 2005; 128: 3221–3228.
[108] Kozora E, Emery CF, Ellison MC, Wamboldt FS, Diaz PT, Make B. Improved neurobehavioral functioning in emphysema patients following lung volume reduction surgery compared with medical therapy. Chest. 2005; 128: 2653–2663.
[109] Fishman A, Martinez F, Naunheim K, et al. A randomized trial comparing lung-volume-reduction surgery with medical therapy for severe emphysema. N Engl J Med. 2003; 348: 2059-2073.
[110] Fessler HE, Scharf SM, Ingenito EP, et al. Physiologic basis for improved pulmonary function after lung volume reduction. Proc Am Thorac Soc. 2008; 5: 416-420.
[111] Ingenito EP, Loring SH, Moy ML, et al. Interpreting improvement in expiratory flows after lung volume reduction surgery in terms of flow limitation theory. Am J Respir Crit Care Med. 2001; 163: 1074-1080.
[112] Ingenito EP, Loring SH, Moy ML, et al. Comparison of physiological and radiological screening for lung volume reduction surgery. Am J Respir Crit Care Med. 2001; 163: 1068-1073.
[113] Martinez FJ, de Oca MM, Whyte RI, et al. Lung-volume reduction improves dyspnea, dynamic hyperinflation, and respiratory muscle function. Am J Respir Crit Care Med. 1997; 155: 1984-1990.
[114] Keller CA, Ruppel G, Hibbett A, et al. Thoracoscopic lung volume reduction surgery reduces dyspnea and improves exercise capacity in patients with emphysema. Am J Respir Crit Care Med. 1997; 156: 60-67.
[115] Sciurba FC. Early and long-term functional outcomes following lung volume reduction surgery. Clin Chest Med. 1997; 18: 259-276.
[116] Gorman RB, McKenzie DK, Butler JE, et al. Diaphragm length and neural drive after lung volume reduction surgery. Am J Respir Crit Care Med. 2005; 172: 1259-1266.
[117] Bloch KE, Li Y, Zhang J, et al. Effect of surgical lung volume reduction on breathing patterns in severe pulmonary emphysema. Am J Respir Crit Care Med. 1997; 156: 553-560.
[118] J?rgensen K, Houltz E, Westfelt U, et al. Effects of lung volume reduction surgery on left ventricular diastolic filling and dimensions in patients with severe emphysema. Chest. 2003; 124: 1863-1870.
[119] Boasquevisque CH, Yildirim E, Waddel TK, Keshavjee S. Surgical techniques: lung transplant and lung volume reduction. Proc Am Thorac Soc. 2009; 6: 66-78.
[120] Fishman A, Martinez F, Naunheim K, et al. A randomized trial comparing lung-volume-reduction surgery with medical therapy for severe emphysema. N Engl J Med. 2003; 348: 2059-2073.
[121] Hamacher J, Büchi S, Georgescu CL, et al. Improved quality of life after lung volume reduction surgery. Eur Respir J. 2002; 19: 54-60.
[122] American Thoracic Society, European Respiratory Society. Standards for the diagnosis and management of patients with COPD. http: //www.thoracic.org/clinical/copd-guidelines/index.php (accesses October 4, 2016).
[123] Richard ZuWallack. The Nonpharmacologic Treatment of Chronic Obstructive Pulmonary Disease. Proceedings of the American Thoracic Society. 2007; 4(7): 549-553.
[124] Ramsey SD, Shroyer AL, Sullivan SD, Wood DE. Updated evaluation of the cost-effectiveness of lung volume reduction surgery. Chest. 2007; 131: 823-832.
[125] Trulock EP, Christie JD, Edwards LB, Boucek MM, Aurora P, Taylor DO, Dobbels F, Rahmel AO, Keck BM, Hertz MI. The Registry of the International Society for Heart and Lung Transplantation: twenty-fourth official adult lung and heart–lung transplant report–2004. J Heart Lung Transplant. 2007; 26: 782–796.
[126] Meyer DM, Bennett LE, Novick RJ. Single vs bilateral lung transplantation for end-stage emphysema: influence of recipient age on survival and secondary endpoints. J Heart Lung Transplant. 2001; 20: 935–941.
[127] Egan TM, Murray S, Bustami RT, Shearon TH, McCullough KP, Edwards LB, Cloke MA, Garrity ER, Sweet SC, Heiney DA, et al. Development of the new lung allocation system in the United States. Am J Transplant. 2006; 6: 1212–1227.
[128] Patel N, Criner GJ. Transplantation in chronic obstructive pulmonary disease. J Chron Obstruct Pulm Dis. 2006; 3: 149–162.
[129] Celli BR, Cote CG, Marin JM, Casanova C, Montes de Oca M, Mendez RA, Pinto Plata V, Cabral HJ. The body-mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease. N Engl J Med. 2004; 350: 1005–1012.
[130] Connors AF Jr1, Dawson NV, Thomas C, Harrell FE Jr, Desbiens N, Fulkerson WJ, Kussin P, Bellamy P, Goldman L, Knaus WA. Outcomes following acute exacerbation of severe chronic obstructive lung disease: the SUPPORT investigators (Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments). Am J Respir Crit Care Med. 1996; 154: 959–967.
[131] Hodgkin JE. Prognosis in chronic obstructive pulmonary disease. Clin Chest Med. 1990; 11: 555–569.
[132] Kanner RE, Anthonisen NR, Connett JE; Lung Health Study Research Group. Lower respiratory illnesses promote FEV1 decline in current smokers but not ex-smokers with mild chronic obstructive pulmonary disease: results from the Lung Health Study. Am J Respir Crit Care Med. 2001; 164: 358–364.
[133] Levine SM, Peters JI, Cronin T. Medium term functional results of single-lung transplantation for endstage obstructive lung disease. Am J Respir Crit Care Med. 1994; 150: 398–402.
[134] Sundaresan RS, Shiraishi Y, Trulock EP, Manley J, Lynch J, Cooper JD, Patterson GA. Single or bilateral lung transplantation for emphysema? J Thorac Cardiovasc Surg. 1996; 112: 1485–1494
[135] Bavaria JE, Kotloff R, Palevsky H, Rosengard B, Roberts JR, Wahl PM, Blumenthal N, Archer C, Kaiser LR. Bilateral versus single lung transplantation for chronic obstructive pulmonary disease. J Thorac Cardiovasc Surg. 1997; 113: 520–522.
[136] Low DE, Trulock EP, Kaiser LR, Pasque MK, Dresler C. Morbidity, mortality, and early results of single versus bilateral lung transplantation for emphysema. J Thorac Cardiovasc Surg. 1997; 113: 1119–1126.
[137] Cassivi SD, Meyers BF, Battafarno RJ, Guthrie TJ. Thirteen-year experience in lung transplantation for emphysema. Ann Thorac Surg. 2002; 74: 1663–1670.
[138] Wanke T, Merkle M, Formanek D, Zifko U, Wieselthaler G, Zwick H, Klepetko W, Burghuber OC. Effect of lung transplantation on diaphragmatic function in patients with chronic obstructive pulmonary disease. Thorax. 1994; 49: 459–464.
[139] Lanuza DM, Lefaiver C, Mc Cabe M, Farcas GA, Garrity E Jr. Prospective study of functional status and quality of life before and after lung transplantation. Chest. 2000; 118: 115–122.
[140] Weistein MS, Martin UJ, Crookshank AD, Chatila W, Vance GB, Gaughan JP, Furukawa S, Criner GJ. Mortality and functional performance in severe emphysema after lung volume reduction or transplant. COPD. 1997; 4: 15–22.
[141] Dorffner R, Eibenberger K, Youssefzadeh S, Wisser W, Zuckermann A, Grabenw?ger F, Metz VM. Diaphragmatic dysfunction after heart or lung transplantation. J Heart Lung Transplant. 1997; 16: 566–569.
[142] McKenna RJ Jr, Benditt JO, DeCamp M, Deschamps C, Kaiser L, Lee SM, Mohsenifar Z, Piantadosi S, Ramsey S, Reilly J, et al.; National Emphysema Treatment Trial Research Group. Safety and efficacy of median sternotomy versus video-assisted thoracic surgery for lung volume reduction surgery. J Thorac Cardiovasc Surg. 2004; 127: 1350–1360.
[143] Pochettino A, Kotloff RM, Rosengard BR, Arcasoy SM, Blumenthal NP, Kaiser LR, Bavaria JE. Bilateral versus single lung transplantation for chronic obstructive pulmonary disease: intermediate-term results. Ann Thorac Surg 2000; 70: 1813–1818.
[144] Haverich A. Experience with lung transplantation. Ann Thorac Surg. 1999; 67: 305–312.
[145] Schols, AM, Scoeters, PB, Mostert, R, et al Energy balance in chronic obstructive pulmonary disease. Am Rev Respir Dis.1991; 143,1248-1252.
[146] Engelen, MP, Schols AM, Baken WC, et al Nutritional depletion in relation to respiratory and peripheral skeletal muscle function in out-patients with COPD. Eur Respir J. 1994; 7, 1793-1797.
[147] Wouters E. Nutritional support in chronic respiratory diseas. In: Schols AM. Eur Respir Mon 2000; 13: 111–31.
[148] E. M. Pouw, G. P. Ten Velde, B. H. Croonen, A. D. Kester, A. M. Schols, E. F. Wouters. Early non-elective readmission for chronic obstructive pulmonary disease is associated with weight loss. Clin Nutr.2000; 19: 95–99.
[149] C. Landbo, E. Prescott, P. Lange, J. Vestbo, T. P. Almdal. Prognostic value of nutritional status in chronic obstructive pulmonary disease. Am J Respir Crit Care Med, 160 (1999), pp. 1856–1861.
[150] A. M. Schols, J. Slangen, L. Volovics, E. F. Wouters. Weight loss is a reversible factor in the prognosis of chronic obstructive pulmonary disease. Am J Respir Crit Care Med.1998; 157: 1791–1797.
[151] K. Gray-Donald, L. Gibbons, S. H. Shapiro, P. T. Macklem, J. G. Martin. Nutritional status and mortality in chronic obstructive pulmonary disease. Am J Respir Crit Care Med.1996; 153: 961–966.
[152] Agusti AG, Noguera A, Sauleda J, Sala E, Pons J, Busquets X. Systemic effects of chronic obstructive pulmonary disease. Eur Respir J.2003; 21: 347–360.
[153] Nicklas BJ, Tomoyasu N, Muir J, Goldberg AP. Effects of cigarette smoking and its cessation on body weight and plasma leptin levels. Metabolism.1999; 48: 804–808
[154] Schols AM, Creutzberg EC, BuurmanWA, et al. Wouters. Plasma leptin is related to proinflammatory status and dietary intake in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med.1999; 160: 1220–1226.
[155] Palange A, Forte S, Felli A, Galassetti P, Serra P, Carlone S. Nutritional state and exercise tolerance in patients with COPD. Chest.1995; 107: 1206–1212.
[156] MacNee. Oxidative stress and lung inflammation in airways disease. Eur J Pharmacol. 2001; 429: 195–207.
[157] Wouters EF. Nutrition and metabolism in COPD. Chest.2000; 117: 274S–280S.
[158] Engelen MP, Schols AM, Lamers RJ, et al. Different patterns of chronic tissue wasting among patients with chronic obstructive pulmonary disease. Clin Nutr. 2005; 8: 275–280.
[159] Schols AM, Soeters PB, Mostert R, et al. Physiologic effects of nutritional support and anabolic steroids in patients with chronic obstructive pulmonary disease: A randomized controlled trial. Am J Respir Crit Care Med. 1995; 152: 1248–1274.
[160] Creutzberg EL, Wouters EFM, Mostert R, et al. Efficacy of nutritional supplementation therapy in depleted patients with chronic obstructive pulmonary disease. Nutrition. 2003; 19: 120–127.
[161] Nutritional supplementation for stable chronic obstructive pulmonary disease. Ferreira IM1, Brooks D, White J, Goldstein R. Cochrane Database Syst Rev. 2012 Dec 12; 12: CD000998. doi: 10.1002/14651858.CD000998.
[162] Rutschmann OT, Janssens JP, Vermeulen B, Sarasin FP. Knowledge of guidelines for the management of COPD: a survey of primary care physicians. Respiratory medicine. 2004; 98(10): 932-7.
[163] Kim DK, Bridges CB, Harriman KH. Advisory Committee on Immunization Practices recommended immunization schedule for adults aged 19 years or older: United States, 2016. Annals of internal medicine. 2016; 164(3): 184-94.
[164] Ngai SP, Jones AY, Tam WW. Tai Chi for chronic obstructive pulmonary disease (COPD). The Cochrane Library. 2016 Jun 7.
[165] Wu W, Liu X, Wang L, Wang Z, Hu J, Yan J. Effects of Tai Chi on exercise capacity and health-related quality of life in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis. International journal of chronic obstructive pulmonary disease. 2014; 9: 1253-1263. doi: 10.2147/COPD.S70862.
[166] Pilkington K, Kirkwood G, Rampes H, Cummings M, Richardson J. Acupuncture for anxiety and anxiety disorders–a systematic literature review. Acupuncture in Medicine. 2007; 25 (1-2): 1-10.
[167] Jean-Louis Corhay, Delphine Nguyen Dang, Hélène Van Cauwenberge, and Renaud Louis. Pulmonary rehabilitation and COPD: providing patients a good environment for optimizing therapy. Int J Chron Obstruct Pulmon Dis. 2014; 9: 27–39. doi: 10.2147/COPD.S52012 PMCID: PMC3869834.
[168] Lilly EJ, Senderovich H. Palliative care in chronic obstructive pulmonary disease. J Crit Care. 2016; 35: 150-154. doi: 10.1016/j.jcrc.2016.05.019.
[169] Pinnock H, Kendall M, Murray SA, Worth A, Levack P, Porter M, MacNee W, Sheikh A. Living and dying with severe chronic obstructive pulmonary disease: multi-perspective longitudinal qualitative study. Bmj. 2011; 342: d142.
[170] Dajczman E, Wardini R, Kasymjanova G, Préfontaine D, Baltzan MA, Wolkove N. six minute walk distance is a predictor of survival in patients with chronic obstructive pulmonary disease undergoing pulmonary rehabilitation. Canadian Respiratory Journal. 2015; 22 (4): 225-9.
[171] Reticker AL, Nici L, ZuWallack R. Pulmonary rehabilitation and palliative care in COPD: two sides of the same coin?. Chronic respiratory disease. 2012; 9 (2): 107-16.
[172] Moss AH, Lunney JR, Culp S, Auber M, Kurian S, Rogers J, Dower J, Abraham J. Prognostic significance of the “surprise” question in cancer patients. Journal of palliative medicine. 2010; 13 (7): 837-40.
[173] Gore, JM, Brophy, CJ, Greenstone, MA How well do we care for patients with end stage chronic obstructive pulmonary disease (COPD)? A comparison of palliative care and quality of life in COPD and lung cancer. Thorax. 2000; 55, 1000-1006.
[174] Carlucci A, Guerrieri A, Nava S. Palliative care in COPD patients: is it only an end-of-life issue? European Respiratory Review. 2012; 21 (126): 347-54.
Author Information
  • Department of Medicine, Emory University School of Medicine, Veterans Affair Medical Center, Atlanta, USA

  • Department of Medicine, Emory University School of Medicine, Veterans Affair Medical Center, Atlanta, USA

  • Department of Medicine, Emory University School of Medicine, Veterans Affair Medical Center, Atlanta, USA

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    Joyce Akwe, Scott Steinbach, Julie Jackson Murphy. (2017). A Review of the Non Pharmacologic Management of Chronic Obstructive Pulmonary Disease. American Journal of Internal Medicine, 4(6), 131-147. https://doi.org/10.11648/j.ajim.20160406.18

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    Joyce Akwe; Scott Steinbach; Julie Jackson Murphy. A Review of the Non Pharmacologic Management of Chronic Obstructive Pulmonary Disease. Am. J. Intern. Med. 2017, 4(6), 131-147. doi: 10.11648/j.ajim.20160406.18

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    AMA Style

    Joyce Akwe, Scott Steinbach, Julie Jackson Murphy. A Review of the Non Pharmacologic Management of Chronic Obstructive Pulmonary Disease. Am J Intern Med. 2017;4(6):131-147. doi: 10.11648/j.ajim.20160406.18

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  • @article{10.11648/j.ajim.20160406.18,
      author = {Joyce Akwe and Scott Steinbach and Julie Jackson Murphy},
      title = {A Review of the Non Pharmacologic Management of Chronic Obstructive Pulmonary Disease},
      journal = {American Journal of Internal Medicine},
      volume = {4},
      number = {6},
      pages = {131-147},
      doi = {10.11648/j.ajim.20160406.18},
      url = {https://doi.org/10.11648/j.ajim.20160406.18},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.ajim.20160406.18},
      abstract = {Over the years, the management of chronic obstructive pulmonary disease has evolved, but given the high mortality and morbidity of COPD, much work still needs to be done. To date, none of the existing pharmacological therapies for COPD has been shown conclusively to modify the long-term decline in lung function. Several trials have been completed to evaluate options that can improve patient symptoms and quality of life. Optimal management of COPD requires both pharmacologic and non-pharmacologic interventions. Some of the non-pharmacologic options for the management of COPD like Oxygen therapy have proven reduction in mortality and mortality, and an improvement in the quality of life. Lung transplant is the only treatment that can stop the decline in lung function. Smoking cessation is the non-pharmacologic intervention with the greatest capacity to influence the natural course of COPD. Pulmonary rehabilitation programs are evidence based, multidisciplinary and comprehensive interventions for patients with COPD. These programs involve patient assessment, exercise training, education, nutrition and psychosocial support. Pulmonary rehabilitation programs are designed to reduce symptoms, optimize functional status, increase participation and reduce health care cost through stabilizing or reversing systemic manifestations of the disease. This article discusses the most used non pharmacologic management of COPD and their usefulness in relieving symptoms and improving the quality of life for patients with severe COPD. These treatment options are used in addition to optimal pharmacologic therapy.},
     year = {2017}
    }
    

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  • TY  - JOUR
    T1  - A Review of the Non Pharmacologic Management of Chronic Obstructive Pulmonary Disease
    AU  - Joyce Akwe
    AU  - Scott Steinbach
    AU  - Julie Jackson Murphy
    Y1  - 2017/02/01
    PY  - 2017
    N1  - https://doi.org/10.11648/j.ajim.20160406.18
    DO  - 10.11648/j.ajim.20160406.18
    T2  - American Journal of Internal Medicine
    JF  - American Journal of Internal Medicine
    JO  - American Journal of Internal Medicine
    SP  - 131
    EP  - 147
    PB  - Science Publishing Group
    SN  - 2330-4324
    UR  - https://doi.org/10.11648/j.ajim.20160406.18
    AB  - Over the years, the management of chronic obstructive pulmonary disease has evolved, but given the high mortality and morbidity of COPD, much work still needs to be done. To date, none of the existing pharmacological therapies for COPD has been shown conclusively to modify the long-term decline in lung function. Several trials have been completed to evaluate options that can improve patient symptoms and quality of life. Optimal management of COPD requires both pharmacologic and non-pharmacologic interventions. Some of the non-pharmacologic options for the management of COPD like Oxygen therapy have proven reduction in mortality and mortality, and an improvement in the quality of life. Lung transplant is the only treatment that can stop the decline in lung function. Smoking cessation is the non-pharmacologic intervention with the greatest capacity to influence the natural course of COPD. Pulmonary rehabilitation programs are evidence based, multidisciplinary and comprehensive interventions for patients with COPD. These programs involve patient assessment, exercise training, education, nutrition and psychosocial support. Pulmonary rehabilitation programs are designed to reduce symptoms, optimize functional status, increase participation and reduce health care cost through stabilizing or reversing systemic manifestations of the disease. This article discusses the most used non pharmacologic management of COPD and their usefulness in relieving symptoms and improving the quality of life for patients with severe COPD. These treatment options are used in addition to optimal pharmacologic therapy.
    VL  - 4
    IS  - 6
    ER  - 

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