COPD (Chronic Bronchitis) (TH2) by Pauline Wong

Instructions

paulinewong1 — 2023-03-08 00:33:46 UTC

Choose a spokesperson
All students in the group are to work on all of the following questions/sections included in the Padlet
You can use diagrams/images other visual resources to explain each respiratory condition.
When we come back to the whole class, the spokesperson will feedback the groups findings, with the teams support

1. Brief definition

paulinewong1 — 2023-03-08 00:33:46 UTC

COPD is an umbrella term which describes long term lung diseases such as emphysema or chronic bronchitis.

Chronic bronchitis is the long term swelling and inflammation of the bronchial tubes. The inflammation causes mucous to build up and causes decreased gas exchange.

2. Is it obstructive or restrictive? Why?

paulinewong1 — 2023-03-08 00:33:46 UTC

OBSTRUCTIVE = Issues with airway resistance

In COPD (Chronic Bronchitis), increased mucus / secretions production from the inflammation => increased airway resistance

3. How does the condition effect lung compliance and/or airway resistance?

paulinewong1 — 2023-03-08 00:33:46 UTC

Bronchitis will significantly increase airway resistance due to bronchial oedema, hypersecretion of mucus, and bacterial colonisation in the airways.

These conditions will cause air trapping, and loss of surface area for gas exchanges and can exacerbate easily. Therefore, it will also subsequently increase the lung compliance.

4. Explain the role of V/Q mismatch in this condition.

paulinewong1 — 2023-03-08 00:33:46 UTC

In COPD (Chronic Bronchitis), V/Q ratio would be lowered = meaning lower ventilation + relatively higher perfusion => causing hypoxaemia

*shunts*

5. How is oxygenation and ventilation affected? Eg. consider O2 content, O2 delivery, alveolar ventilation

paulinewong1 — 2023-03-08 00:33:46 UTC

- Oxygen Content: lowered due to lower oxyhaemoglobins
- Oxygen Delivery: impaired, DO2 = CO x CaO2 [(Hb x 1.39 x SaO2) + (PaO2 x 0.003)] x10 ~ Cardiac Output ? other cormorbilities
- Alveolar ventilation: lowered

*Oxygen-Haemoglobin Dissociation Curve shifts to right (Reduced Hb-O2 affinity) = Increased release of O2 from HB to the tissues
*Gas Trapping => increased thoracic pressure => decreased venous return => decreased preload => decreased CO / perfusion

6. What type of respiratory failure would this condition lead to?

paulinewong1 — 2023-03-08 00:33:46 UTC

COPD chronic bronchitis could lead to Type 2 Respiratory Failure.

Type 2 RF means there’s a pCO2 greater than 50mmHg. This is because the lungs are failing to eliminate carbon dioxide due to insufficient alveolar ventilation.
Hypoxaemia is also an issue with a pO2 of less than 60mmHg and happens when there is not enough oxygen exchange to meet metabolic needs.

7. What are the typical ABGs and why?

paulinewong1 — 2023-03-08 00:33:46 UTC

pH: < 7.35 (Acidosis) or normal (compensated)
PaO2: Hypoxaemia
SaO2: Aim: 88-92% - *Hypoxic Respiratory Drive*
pCO2: >45mmol/L (Acidosis)
HCO3-: ? >28 or on the higer side ?metabolic compensation, or normal

8. What are the typical clinical manifestations/ patient assessment data? (relate these to pathophysiology concepts already described)

paulinewong1 — 2023-03-08 00:33:46 UTC

CNS: Confusion, fatigue, restlessness from chronic hypercapnia.
CVS: Tachycardia due to compensation.
RESP: Increased WOB, SOBOE, chronic productive cough, altered respiratory drive, RR (normal or abnormal), wheeze/crackles on auscultation
GIT: High acidic environment => ulceration formation, Obstruction/decreased bowel motions (?Reduced oxyhemoglobin)
RENAL: AKI (? reduced oxyhemoglobin)
SKIN: Warm to touch
MOBILITY: Shortness of breath on exertion

9. OPTIONAL: Important vocabulary (include list of key vocabulary referenced; if you do not know the term(s), look up and add a definition for the word(s))

paulinewong1 — 2023-03-08 00:33:46 UTC

Respiratory drive: The intensity of the output by the respiratory centers determines the effort of the respiratory muscles