Effects of a comprehensive, inpatient pulmonary rehabilitation programme in a cachectic patient with very severe COPD and chronic respiratory failure

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Fältnamn	Indikatorer	Metadata
000		03920naa a2200469 4500
001		oai:gup.ub.gu.se/283870
003		SwePub
008		240528s2019 \| \|\|\|\|\|\|\|\|\|\|\|000 \|\|eng\|
024	7	a https://gup.ub.gu.se/publication/2838702 URI
024	7	a https://doi.org/10.1183/20734735.0186-20192 DOI
040		a (SwePub)gu
041		a eng
042		9 SwePub
072	7	a ref2 swepub-contenttype
072	7	a art2 swepub-publicationtype
100	1	a Franssen, F. M. E.4 aut
245	1 0	a Effects of a comprehensive, inpatient pulmonary rehabilitation programme in a cachectic patient with very severe COPD and chronic respiratory failure
264		c 2019-09-01
264	1	b European Respiratory Society (ERS),c 2019
520		a Pulmonary rehabilitation (PR) is a comprehensive intervention based on a thorough patient assessment followed by personalised interventions designed to improve the physical and psychological condition of patients with chronic respiratory diseases and to promote the long-term adherence to health-enhancing behaviours [1]. While the clinical importance of physical activity is recognised across all stages of disease, the Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2019 strategy for chronic obstructive pulmonary disease (COPD) states that patients that remain highly symptomatic and/or those with a history of moderate or severe exacerbations despite optimal pharmacotherapy are indicated for PR [2]. Improvements in symptoms, increases in quality of life and gains in functional capacity after PR are independent of age, sex or the baseline degree of airflow limitation [3, 4]. However, it is known that patients with higher symptoms of dyspnoea, worse functional capacity and poor health status at baseline are more likely to be good responders to PR [5]. While PR is traditionally applied in clinically stable patients, there is increasing evidence for its beneficial effects following hospitalisations [6] and in those with frequent exacerbations [5]. In patients with very severe disease awaiting lung transplantation significant improvements in exercise capacity and health status were reported after short-term comprehensive PR [7]. Moreover, an increasing number of specific (non-)pharmacological interventions are available and can be combined with PR in the subgroup of patients with very advanced disease, including neuromuscular electrical stimulation (NMES), noninvasive ventilatory support and anabolic agents. Finally, PR may be an appropriate setting to introduce advance care planning (ACP) [8]. The role of these personalised and targeted interventions will be highlighted in this case report.
650	7	a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Lungmedicin och allergi0 (SwePub)302192 hsv//swe
650	7	a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Respiratory Medicine and Allergy0 (SwePub)302192 hsv//eng
653		a neuromuscular electrical-stimulation
653		a muscle training modalities
653		a obstructive lung-disease
653		a noninvasive ventilation
653		a dyspneic individuals
653		a anabolic-steroids
653		a efficacy
653		a therapy
653		a decline
653		a mass
653		a Respiratory System
700	1	a Vanfleteren, Lowie E G Wu Gothenburg University,Göteborgs universitet,Institutionen för medicin,Institute of Medicine4 aut0 (Swepub:gu)xvanlo
700	1	a Janssen, D. J. A.4 aut
700	1	a Wouters, E. F. M.4 aut
700	1	a Spruit, M. A.4 aut
710	2	a Göteborgs universitetb Institutionen för medicin4 org
773	0	t Breathed : European Respiratory Society (ERS)g 15:3, s. 227-233q 15:3<227-233x 1810-6838x 2073-4735
856	4	u https://breathe.ersjournals.com/content/breathe/15/3/227.full.pdf
856	4 8	u https://gup.ub.gu.se/publication/283870
856	4 8	u https://doi.org/10.1183/20734735.0186-2019

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