Sasikumar, P (2012) An Analysis of ECG, Chest X-Ray, Pulmonary Function Tests, Pulse Oximetry, Haematocrit Abnormalities in Chronic Obstructive Pulmonary Disease Patients. Masters thesis, K.A.P. Viswanatham Government Medical College, Tiruchirappalli.
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Abstract
INTRODUCTION : Chronic Obstructive Pulmonary Disease (COPD) is a major cause of chronic morbidity and mortality throughout the world. Many people suffer from this disease for years and die prematurely from it or its complications. COPD is the fourth leading cause of death in the world9 and further increases in its prevalence and mortality can be predicted in the coming decades. In the definition of COPD, the phrase “preventable and treatable” has been incorporated following the ATS/ERS recommendations to recognize the need to present a positive outlook for patients, to encourage the health care community to take a more active role in developing programs for COPD prevention and to stimulate effective management programs to treat those with the disease. The chronic airflow limitation characteristic of COPD is caused by a mixture of small airway disease (obstructive bronchiolitis) and parenchymal destruction (emphysema), the relative contributions of which vary from person to person. COPD has a variable natural history and not all individuals follow the same course. However, COPD is generally a progressive disease, especially if a patient's exposure to noxious agents continues. The impact of COPD on an individual patient depends on the severity of symptoms (especially breathlessness and decreased exercise capacity) systemic effects, and any comorbidities the patient may have not just on the degree of airflow limitation. AIM OF THE STUDY : 1. To study age and sex distribution in COPD patients. 2. To study the risk factors in COPD patients. 3. To study about the duration and influence of smoking habit in the development & progression of COPD. 4. To study the presenting symptoms in COPD patients. 5. To study the physical signs in COPD patients. 6. To Study the Pulse oximetry values to detect hypoxemia, prognosis, to plan oxygen therapies in chronic obstructive pulmonary disease. 7. To study the correlation between Hemoglobin level and severity of disease. 8. To study the correlation between Hematocrit level and severity of disease. 9. To assess the severity of chronic obstructive pulmonary disease by the pulmonary function tests. 10. To study chest x-ray findings, ECG findings in COPD patients. MATERIALS AND METHODS : SETTING: The study was conducted in Annal Gandhi Memorial Government Hospital, Trichy which is attached to K. A. P. Viswanatham Government Medical College, Trichy. DESIGN OF STUDY: It was an observational type of study. Interview technique was used to collect information on a predesigned proforma. PERIOD OF STUDY: It was conducted in a time period from January 2011 to October 2011. SAMPLE SIZE: Hundred cases of Chronic Obstructive Pulmonary Disease. SELECTION OF STUDY SUBJECTS: COPD patients above 40 years of age, admitted in medical wards with the diagnosis of Chronic Obstructive Pulmonary Disease. INCLUSION CRITERIA: Adult males and females admitted in the medical wards with symptoms suggestive of airway obstruction of more than 2 years duration and in who clinical diagnosis of chronic obstructive pulmonary disease was made were included in the study. All these patients were subjected to clinical examination, ECG, chest X-ray, pulmonary function testing, pulse oximetry and Hematocrit analysis On spirometry the presence of COPD was diagnosed by post bronchodilator values of (I) Forced expiratory volume in first second / Forced vital capacity (FEV1/FVC) less than 70%. All patients were clinically stable at the time of conducting pulmonary function test. EXCLUSION CRITERIA: Cases which excluded from the study were patients with primary diagnosis of bronchial asthma, pulmonary tuberculosis, Bronchiectasis, cases of sleep apnoea syndromes and patients with post infarction failure. CONCLUSIONS : Majority of the patients were in the age group of 61-70 years. COPD was seen predominantly in male patients and majorities were smokers who have more than 20 smoke pack years. • Because of urbanization, prevalence of COPD increasing in urban. • In the majority of patients the duration of illness was 2-5 years. Cough and breathlessness were present in all patients. • Wheeze is not the predominant symptoms in routine COPD patients. • Diminished chest movements, crepitations, rhonchi, were present in majority of patients. • As the number of cigarettes/day and duration increases the severity of the disease also increases in the studied population. • In females exposure to smoke due to burnt fuel is the risk factor. • In the study, about 40 % of cases were in stage III disease. • As the severity & duration of the disease increases they are more prone to develop hypoxia and polycythemia as a complication. In our study 8 patients had hypoxia, as assessed by pulse oximetry, but no patient was in polycythemic range of hemoglobin or hematocrit values, this may be due to malnutrition. • Clinical examination, ECG and chest X-ray may be normal in COPD patients. So diagnosis and severity should be based on Pulmonary Function Test. • Pulse Oximetry is the best bedside tool to assess the hypoxemia in COPD patients and very useful to oxygen therapy. • Spirometry is the definitive and gold standard investigation for diagnosis of chronic obstructive pulmonary disease, assess the severity of disease, reversibility and follow up.
| Item Type: | Thesis (Masters) |
|---|---|
| Uncontrolled Keywords: | ECG, Chest X-Ray, Pulmonary Function Tests, Pulse Oximetry, Haematocrit Abnormalities, Chronic Obstructive Pulmonary Disease Patients. |
| Subjects: | MEDICAL > General Medicine |
| Depositing User: | Subramani R |
| Date Deposited: | 13 Feb 2018 16:39 |
| Last Modified: | 13 Feb 2018 16:39 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/5692 |
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