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pulmonary rehabilitation

Understanding Pulmonary Rehabilitation

Patients with chronic respiratory conditions such as Asthma, Chronic Obstructive Pulmonary Disease (COPD) or Interstitial Lung Disease (ILD) often have difficulty with their activities of daily living due to shortness of breath. If you have been newly diagnosed with a chronic respiratory condition or suffer from other conditions such as pulmonary hypertension, cystic fibrosis, or have upcoming lung surgery​​​ your health care provider may have suggested Pulmonary Rehabilitation (PR). Like other respiratory conditions, COVID-19 can cause respiratory complications and lasting lung damage. Some people may also develop “long COVID,” which occurs when COVID-19 symptoms linger for weeks or months after acquiring the initial infection. Some people refer to this group as “long haulers.”

What is Pulmonary Rehabilitation (PR)?

Pulmonary Rehabilitation (PR) is a comprehensive rehabilitation program designed specifically for patients with lung disease that has been shown to improve quality of life and relieve shortness of breath. PR is a two-step program that includes education and exercise to help you learn more about your lungs and your disease.

Your rehab team will often include:
  • Doctor
  • Nurse
  • Respiratory therapist
  • Physical therapist
  • Exercise Specialist
  • Dietitian

Overall, you will learn how to manage your breathing problems, increase your energy, and decrease your breathlessness. Typically, a PR program will be offered in a group setting, allowing you the opportunity to meet others suffering from similar conditions. A community environment allows you to speak with others with similar lung problems, get useful tips, and discuss topics that arise when dealing with a chronic condition.

What is the role of PR in the Treatment of COVID-19?

Some people who recover from COVID-19 may need pulmonary rehabilitation to help them resume normal activities after staying in the hospital, or following periods of prolonged isolation. Pulmonary rehabilitation can help those with decreased strength begin to move more, gradually building up their stamina. PR for those recovering from COVID-19 can help:

  • Restore function to the muscles
  • Reduce the likelihood of mental health conditions that may occur as a result of limited mobility
  • Enable people to return to their normal lives

Step ONE: Education

PR programs help patients to improve their exercise capacity which helps them get back to daily life. The education portion of the program will help you gain a better understanding on how to best manage your breathing problems so that your breathing is not in charge of you. You will also learn things such as how to pace your breathing with your activities, take your medications, and what questions to ask your healthcare provider.

Step TWO: Exercise

Step TWO is the exercise component. PR provides education on breathing techniques to help you cope with the symptom of breathlessness The exercise program is led by the PR staff; they will monitor you as you exercise to ensure your safety. The exercises are designed for your specific needs and will start at a level that you can handle. The amount of time you exercise will be increased in time and the level of difficulty will change based on your ability. As your muscles get stronger, you will be able to exercise longer, be less tired, and have less shortness of breath.

Takeaway

What you learn during PR should be used throughout life to avoid hospitalizations, complications, and other issues. Most importantly, it provides a support system by allowing patients to meet other people with the same experience. Pulmonary Rehabilitation forms an integral part of the comprehensive care of patients with respiratory conditions. Always consult with your doctor before starting a new exercise routine. People recovering from COVID-19 should also seek help if their symptoms are severe or suddenly worsen.

 

Sources:

National Institues of Health

American Lung Association

X-PLO₂R™ Portable Oxygen Concentrator Receives FDA Clearance

Belluscura is excited to announce that the X-PLO2R portable oxygen concentrator has been granted 510(K) clearance from the U.S. Food and Drug Administration (FDA). We are extremely proud to bring this technology to the market, in doing our part to help improve the quality of life for millions of people worldwide who suffer from chronic lung diseases, such as the Chronic Obstructive Pulmonary Disease (COPD), respiratory distress caused by COVID-19, and many other respiratory disorders.

View the full press release and continue to follow Belluscura for future updates.

 

Lungs and the Respiratory System

Lungs are very important since every cell in our body needs oxygen to function. Oxygen is inhaled into your lungs and then moves throughout your body via the bloodstream. Carbon dioxide is then expelled from your body when you breathe out.

The respiratory system also performs other vital roles in your body, such as moisturizing the air you breathe to be the right temperature and humidity level. It also acts as a filter to protect you from harmful substances through sneezing, coughing and swallowing. Let us break down what the respiratory system is and what it does.

Diagram of the Respiratory System

The nose is the main entryway for air into the body. Your nose hairs act as a filter to stop particles that should not enter your body. The mouth is an alternate entryway, especially when the nose is blocked or you are breathing heavily, like during a workout.

The sinuses, or hollow spaces located around the eyes and nose, fill with air and are responsible for regulating the temperature of the air you inhale, as well as humidity.

Inhaled air collects in your throat, which then passes through your windpipe, or trachea. The windpipe splits into 2 separate airways called bronchial tubes— one located in each lung. These 2 bronchial tubes split again into the 5 different lobes in your lungs. Openings in bronchial tubes are supported by cartilage, which is a thick tissue. The end of the tubes split further into bronchioles.

Lining the bronchial tubes are cilia, which are tiny hairs that move mucus out to your throat.

At the end of the bronchioles, there are air sacs, or alveoli. Gas exchange occurs in these tiny air sacs, and according to National Heart, Lung, and Blood Institute, your lungs have around 150 million of them. The air sacs are elastic, so they can expand and contract, allowing them to take in oxygen and expel carbon dioxide.

Capillaries are blood vessels located in the walls of the air sacs. Blood with carbon dioxide is pumped from the right ventricle through the pulmonary artery to the air sacs where the carbon dioxide is released into the lungs. Simultaneously, oxygen from the air within the air sacs diffuses into capillaries that are connected to the pulmonary vein which brings oxygenated blood to the left atrium of the heart to later be pumped throughout the body.

The right lung has 3 different sections called lobes, and the left lung has 2. The lobes contain sponge-like tissue, and it travels through the bronchial tubes in and out of the lobes. The pleura is a pair of membranes around each lobe and acts as a lining between your chest wall and lungs.

The diaphragm is a large muscle that separates your abdominal cavity and your chest cavity. It plays a major role in the inflation of the lungs.

Ribs are the bones protecting everything in your chest cavity. They also help the lungs with expansion and contraction.

Takeaway

Together, your respiratory system is responsible for your breathing without you even realizing it. Each of these smaller parts work together to make up something that is quite complex and fascinating. Staying in good health and taking care of your lungs will ensure your respiratory system functions as it should.

Sources:

https://www.lung.org/lung-health-diseases/how-lungs-work

https://www.nhlbi.nih.gov/health-topics/how-lungs-work

 

 

Understanding A COPD Diagnosis: Key Facts

If you or someone you know has recently been diagnosed with COPD, you may be wondering what exactly that means. COPD stands for Chronic Obstructive Respiratory Disease. COPD is composed of different respiratory diseases that cause troubled breathing.

The term COPD can be used to describe a singular respiratory disorder, or more than one. COPD encompasses chronic bronchitis, emphysema, asthma, and some forms of bronchiectasis, as well as any combination of the four. According to the American Lung Association, over 16 million Americans are diagnosed with COPD as of October 2020, but millions more suffer from it without being diagnosed.

The group of diseases in which COPD refers to cause airflow obstruction and trouble with breathing. COPD is chronic, meaning it is long-lasting and constantly present. Each individual case of COPD is different, and some cases are more severe than others. The most common cases of COPD include symptoms of both chronic bronchitis and emphysema.

COPD Explained

What is Happening in Your Body?

Your particular case of COPD will determine what is happening within your body. Cases that include chronic bronchitis will cause swelling and increased mucus production in the lung airways, or bronchial tubes. This causes breathing to become more difficult since your airways are inflamed and narrowed with mucus blocking them. Cases including emphysema cause destruction of the air sacs, or alveoli. The air sacs are responsible for oxygen exchange within the lungs, and they lose their elasticity by becoming destroyed. This causes breathing difficulty since the loss of elasticity leads to air being trapped inside the air sacs, making it harder to get oxygen in and carbon dioxide out.

Symptoms of COPD

Some of the most common symptoms include:

  • Increased shortness of breath
  • Frequent coughing (with or without mucus)
  • Wheezing
  • Tightness in the chest

Remember, not all cases of COPD will have the same symptoms. Other symptoms include frequent respiratory infections, lack of energy and unintended weight loss.

What Causes COPD?

COPD is mainly caused by inhaling lung irritants, and smoking is the #1 cause. People, however, do not realize that other potential lung irritants that can also cause COPD include exposure to air pollution, fumes, chemicals, secondhand smoke and dust particles. Oftentimes, inhaling these irritants can be work-related. Working in construction, mining or welding are examples of occupations that increase the risk of obtaining COPD due to increased exposure to lung irritants. A rare genetic factor called alpha-1 antitrypsin deficiency is also known to cause COPD and is passed from parents to their children.

Comorbid conditions seem to be more common in people with COPD than in people with other medical problems. These conditions may include:

  • High blood pressure
  • High cholesterol
  • Heart disease
  • Diabetes
  • Osteoporosis
  • Depression
  • Arthritis
  • Sleep Apnea
  • Cancer
  • Other medical problems

One reason for these additional problems may relate to the lung inflammation that occurs in people with COPD.

What is a Flare-Up?

A COPD flare-up, or exacerbation, is when your symptoms are considerably worse than usual. Some can be treated at home, but more severe flare-ups can require a visit to the hospital. Flare-ups are triggered by further lung inflammation. This can be from exposure to smoke, pollution or allergens as well as contracting the flu or pneumonia. Symptoms to look out for include:

  • Shortness of breath without physical activity
  • Increased mucus
  • Excessive coughing or wheezing
  • Lower blood  oxygen saturation level than normal

Those symptoms can usually be treated at home with antibiotics or inhalers, but the following list of symptoms require professional help.

  • Increased heart rate
  • Being unable to catch your breath
  • Lips or fingernails turn blue or gray
  • Treatments are not working

Does COPD Have a Cure?

COPD is a progressive disease, which means that it gets worse over time. Unfortunately, there is no cure, but luckily many treatment options are available to improve the quality of life. Bronchodilator and steroid medications are available through inhalers to relax the lungs, as well as oral anti-inflammatory medications. Oxygen therapy is also a popular treatment option to help patients achieve healthy blood oxygen levels, which is difficult to maintain when you have COPD. Oxygen therapy allows you to still be active and live a normal life while getting the oxygen into your body that you need, especially with the availability of portable oxygen concentrators. Pulmonary rehabilitation is another option for those with COPD. It helps patients adjust to and get educated about their conditions. Pulmonary rehabilitation programs often provide support and exercise training as well as breathing techniques that are personalized based on specific patient needs.

Living with COPD

Activities of daily living, such as completing chores or bathing, can be harder to accomplish due to shortness of breath. You may have to take constant breaks to catch your breath. Activities will take your energy to perform, so you will get physically exhausted more easily. Living with COPD means slowing down in order to control your breathing and to prevent tiring yourself too quickly. Living with COPD has its challenges, but modifying some activities of daily living can improve your quality of life and help you better manage your disease.

Takeaway

Although COPD is a life-long condition, you can still live a fulfilling life with the help of treatment options, although you may have to slow your pace. COPD takes a toll on your body, so taking care of yourself, monitoring your symptoms and following your doctor’s orders are top priorities.

Sources

https://www.cdc.gov/copd/features/copd-symptoms-diagnosis-treatment.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Ffeatures%2Fcopd-awareness-month%2Findex.html

https://www.copdfoundation.org/What-is-COPD/Understanding-COPD/What-is-COPD.aspx

https://www.hse.gov.uk/copd/causes.htm

https://www.lung.org/lung-health-diseases/lung-disease-lookup/copd/learn-about-copd#:~:text=With%20COPD%2C%20the%20airways%20in,the%20waste%20gas%20carbon%20dioxide.

https://medlineplus.gov/copd.html

https://www.nhlbi.nih.gov/health-topics/copd

https://www.nps.org.au/consumers/chronic-obstructive-pulmonary-disease-copd-explained

COPD Awareness: Understanding the Diagnosis and Stages

Awareness

Being told you have chronic obstructive pulmonary disease (COPD) can be overwhelming. COPD is a progressive disease that obstructs the airflow, making it difficult to breathe and get enough oxygen into your lungs. According to the Chest Foundation, COPD is the third leading cause of death in the US and impacts roughly 24 million Americans.

COPD is made up of two diseases; emphysema accounts for 33 percent, and chronic bronchitis accounts for the remaining 64 percent of diagnosed cases. Emphysema occurs due to the damage that happens to the air sacs in the lungs. These air sacs overfill with air and lose their elasticity which makes it hard to exhale the excess air. In chronic bronchitis, the airways become swollen and inflamed and produce large amounts of mucus. The increased production of mucus obstructs the airways, narrows them, and makes it hard to breathe.

The Global Initiative for Chronic Obstructive Lung Disease (GOLD) has classified four stages in which your healthcare provider will determine what stage of COPD you are in. This will help them determine the best treatment plan for you.

Symptoms

The first part of diagnosing your condition will consist of assessing symptoms. It will be important to provide your healthcare provider with the symptoms you have been having that have led you to seek medical attention. Common COPD symptoms include:

  • Shortness of breath
  • Chronic cough
  • New or increased wheezing
  • Coughing up phlegm or and increase in phlegm

Risk Factors

It will be important for your healthcare provider to know if you have had or are currently exposed to any risk factors. Risk factors could include things such as:

  • Genetic factors
  • Abnormalities from birth
  • Tobacco smoke
  • Smoke from cooking/heating fuels
  • Dust
  • Vapor
  • Fumes or other inhaled chemicals

Spirometry

Spirometry will play a large role in your COPD diagnosis. Once you have sought medical care for COPD related symptoms and you have discussed your risk factors, the next step will be for your healthcare provider to order spirometry.

Spirometry is a common breathing test used to see how well your lungs are working by taking a few test measurements while you breathe into a machine. Spirometry will measure the air you breathe in, the air you breathe out, and how quickly you breathe out.

One of the initial spirometry tests that will be performed is called the Forced Vital Capacity (FVC) measurement or the amount of forced air that you can exhale and inhale into the machine. An equally important measurement is the calculation based on the Forced Expiratory Volume in One Second (FEV1). This is the amount of air you can breathe out of the lungs in the first one second of forced expiration.

Your FEV1 is based on factors including your age, sex, height, and ethnicity.  Your healthcare provider will compare your results to a healthy individual and any deviations in measurements are what will lead to a sign of what might be causing your problems.

You will be given a breathing treatment with medication to help open your lungs such as a bronchodilator before you start the test. This is to ensure your lungs are performing at their best.

After your test is completed, your healthcare provider will review the measurements and see which of the four GOLD stages of COPD you fall into based on your results. This testing will serve as a follow-up assessment to determine what other therapies can work for you and to monitor you as the disease progresses.

Four Stages of GOLD

Your spirometry results, particularly your FEV1, will fall into one of the four GOLD classifications of severity which is how your COPD stage will be determined.

GOLD 1
  • Mild Stage, Stage I COPD
  • FEV1  greater than/or equal to 80% of predicted test results compared to a healthy individual
  • In this stage, you will likely experience very mild symptoms
GOLD 2
  • Moderate Stage, Stage II COPD
  • FEV1 between 50 – 79% of predicted test results compared to a healthy individual
  • Symptoms include shortness of breath with activity, cough, and sputum production
GOLD 3
  • Severe Stage, Stage III COPD
  • FEV1  between 30 – 49% of predicted test results compared to a healthy individual
  • In this stage, you may experience shortness of breath, fatigue, and a lower tolerance to physical as well as more frequent COPD exacerbations
GOLD 4
  • Very Severe, Stage III COPD sometimes referred to as End-Stage COPD
  • FEV1 less than 30 % of predicted test results compared to a healthy individual
  • In this stage, you may find that your quality of life is significantly decreased, and you may experience severe and life-threatening exacerbations

Takeaway

COPD is a chronic disease that cannot be cured and as time goes on, the disease progresses. Certain treatments and lifestyle changes can help you manage your symptoms and improve your quality of life. It is important to seek out a healthcare provider who will work with you to improve your breathing.

Sources:

https://foundation.chestnet.org/lung-health-a-z/chronic-obstructive-pulmonary-disease-copd/

https://www.who.int/respiratory/copd/burden/en/

https://goldcopd.org/

Did You Know That Certain Foods Can Boost Your Immune System?

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New FDA Guidance Provides a Policy Designed to Expand the Availability of Respiratory Devices, Including Oxygen Concentrators, During the COVID-19 Pandemic

Today, the U.S. Food and Drug Administration (FDA) issued this immediately in effect guidance: Enforcement Policy for Ventilators and Accessories and Other Respiratory Devices During the Coronavirus Disease-2019 (COVID-19) Public Health Emergency.

WHITE OAK, MD  (Photo by Sarah Silbiger/Getty Images)

 
The FDA believes the policy set forth in this guidance may help address urgent public health concerns by helping to expand the availability of devices that facilitate respiration, including ventilators and accessories. Learn more.

Belluscura and its research partner, Separation Design Group, announce the filing of a patent application on a modular portable oxygen enrichment ventilation system

LONDON, UK, PLANO, TX AND WAYNESBURG, PA, March 13, 2020.  Belluscura PLC, in conjunction with its exclusive research partner Separation Design Group, announced today the filing of a patent application covering novel modular portable oxygen enrichment ventilation systems for treating patients suffering from chronic obstructive pulmonary diseases (COPD) and acute respiratory distress syndrome (ARDS) brought on by such diseases as COVID-19.

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Belluscura announces filing of a patent application on an oxygen enrichment device and system for treating acute respiratory distress (ARDS), including ARDS caused by the recent Coronavirus

LONDON, UK AND PLANO, TX, February 6, 2020.  Belluscura PLC, in conjunction with its exclusive research partner Separation Design Group, announced today the filing of a patent application covering novel integrated portable extracorporeal oxygenation and carbon dioxide removal systems for treating patients suffering from acute respiratory distress syndrome (ARDS).

The latest patent application covers devices and systems for treating people suffering from ARDS including patients suffering from the recent coronavirus in Wuhan, China.  The primary cause of death from respiratory viruses like the coronavirus and influenza, are the result of the fluids accumulating inside the alveoli (the tiny air sacs of the lungs) which ultimately leads to the failure of the transfer of oxygen to and carbon dioxide out of the blood.  The current primary treatment for ARDS is oxygen therapy along with ventilator support.

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Respiratory Care Week Celebrates Respiratory Therapists

Respiratory Care Week is the last full week of October and it is designated to honor and recognize Respiratory Therapists. You may have heard the term “Respiratory Therapist” before, but do you know what Respiratory Therapists actually do?

Respiratory Therapists (RT) are certified medical professionals who specialize in providing healthcare for your lungs. There are different types of respiratory therapists, including emergency, pediatric, adult and geriatric, with RTs specializing in one or more areas.

How does one become an RT? How do you know if you need an RT? What do you look for in an RT? Read more: https://www.healthline.com/health/what-is-a-respiratory-therapist