Chest
Original Research: CopdSystemic Cytokines, Clinical and Physiological Changes in Patients Hospitalized for Exacerbation of COPD
Section snippets
Methods and Materials
We studied 20 consecutive patients who had been admitted with an ECOPD to Caritas St. Elizabeth's Hospital. The protocol approved by the institutional review board of the hospital was signed by all participants. The diagnosis of ECOPD was confirmed if patients had two or more of the following three symptoms of exacerbations16: worsened dyspnea; worsened sputum volume and/or change in its color; and new or worsening cough. All patients had received a diagnosis of COPD based on smoking history (>
Results
The characteristics of the patients are shown inTable 1. The patients were elderly ex-smokers with preexacerbation mean FEV1values of 41 ± 13% predicted. On hospital admission, the majority of patients (67%) required oxygen therapy and had increased WBC counts with predominant segmented neutrophils and increased band forms.
Discussion
There were several findings in this study of patients admitted with an ECOPD. First, the most prevalent symptom was measurable dyspnea. Physiologically, there was tachypnea and decreased IC. The IC improved rapidly and correlated with tachypnea. In contrast, the changes in FEV1and FVC were more gradual, being significant only after hospital discharge. Second, the plasma levels of IL-6, IL-8, and LTB4were increased at the moment of the initial evaluation, with rapid reductions for IL-6 and IL-8
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This research was supported by an unrestricted grants from GlaxoSmithKline, Thoracic Overholt Foundation.
Drs. Masdin and Linacre are employees of GlaxoSmithKline, a pharmaceutical company with financial interest in COPD. All of the authors have reported to the ACCP that no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestjournal.org/misc/reprints.shtml).