Respiratory disease in practice - 2011

The long-term sequelae of mechanical ventilation
Neil H Crooks, Fang Gao and Gavin D Perkins
pp 1-5
As medical management and intensive care unit (ICU) interventions have evolved, we have seen an increase in the number of survivors of critical illness. These patients may suffer long-term complications. Therefore, it is important to anticipate and recognise these complications, and modify practice to minimise or eliminate them.
Comment: Getting to the heart of exacerbations
Philip W Ind
pp 3-3
Acute exacerbations of COPD are common and serious. In-hospital mortality is >=10% and the death rate at one year is >=25%. Acute exacerbations are associated with decreased health status, reduced lung function, further exacerbations and admissions, and cardiopulmonary complications. They are responsible, to a large extent, for the winter ‘bed pressures’ in hospitals. There are obvious parallels between heart attacks and these ‘lung attacks’. Adoption of this term may help to emphasise their severity and consequences to patients and healthcare providers, and may drive better disease stratification and improve organisation of future care.
Will stratified medicine change the future of asthma management?
John J Lima
pp 6-7
Matching individual patients to medicine using the patient’s own genotype is the overarching goal of personalised medicine, and is known as pharmacogenetics or pharmacogenomics.
Managing the provision of palliative care for COPD patients
Hilary Pinnock
pp 8-11
In the UK, about 25,000 deaths are attributed to chronic obstructive pulmonary disease (COPD) every year. There is increasing concern that people with very severe COPD do not receive the supportive care they need and from which they could benefit. This paper describes the symptoms of people with severe COPD and their management, investigates the barriers to providing palliative care and considers strategies for improving supportive care.