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General Management Issues in COPD: Sleep, Travel and Preoperative Management

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COPD

Part of the book series: Respiratory Medicine ((RM))

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Key Points

Sleep disorders in chronic obstructive pulmonary disease (COPD)

  • Sleep disorders are prevalent in patients with COPD.

  • Insomnia is reported in as much as 50% of patients with COPD.

  • Optimal airway targeted pharmacotherapy of COPD may improve sleep in these patients.

  • Attention should be paid to use of sedatives and narcotics in patients with COPD and insomnia as some of the medications may affect ventilation.

  • OSA is not more frequent in COPD compared to a matched population without COPD, however, the severity of hypoxia or prevalence of hypoxia without OSA is more in COPD patients.

Travel and COPD

  • Travel to high altitude or air travel may result in hypoxia in patients with COPD.

  • Severity of hypoxia during the flight not only depends on the baseline arterial partial pressure of O2 but also on severity of airflow obstruction and presence of other comorbid conditions.

  • O2 need during the flight or travel to high altitude can be determined either empirically or by hypoxia-altitude simulation test (HAST).

  • Guidelines recommend having PaO2 of 50–55 mmHg at high altitude and during the flight.

Perioprative care of COPD

  • A comprehensive assessment by various practitioners involved in the operation is needed.

  • Patient education and smoking cessation plays an important role in outcome of a surgery in these patients.

  • Optimization of pharmacologic and non-pharmacologic therapies for COPD and other co-morbidities will improve outcomes of a surgery.

  • Implementation of early post-op mobilization, incentive spirometry, and avoidance of shivering may help to avoid complications post surgery.

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Author information

Authors and Affiliations

  1. Michael E. DeBakey Veterans Administration Medical Center, Baylor College of Medicine, Houston, TX, USA

    Amir Sharafkhaneh, Hossein Sharafkhaneh & Max Hirshkowitz

  2. Cardiovascular Institute, TriCity Medical Center, Oceanside, CA, USA

    Mohammed Jamshidi

Authors
  1. Amir Sharafkhaneh
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  2. Mohammed Jamshidi
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  3. Hossein Sharafkhaneh
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  4. Max Hirshkowitz
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Editors and Affiliations

  1. , Section of Pulmonary and Critical Care M, Baylor College of Medicine, 1504 Taub Loop, Houston, 77030, Texas, USA

    Nicola A. Hanania

  2. Michael E. DeBakey VA Medical Center, Baylor College of Medicine, 2002 Holcombe Blvd., Houston, 77030, Texas, USA

    Amir Sharafkhaneh

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Sharafkhaneh, A., Jamshidi, M., Sharafkhaneh, H., Hirshkowitz, M. (2011). General Management Issues in COPD: Sleep, Travel and Preoperative Management. In: Hanania, N., Sharafkhaneh, A. (eds) COPD. Respiratory Medicine. Humana Press. https://doi.org/10.1007/978-1-59745-357-8_17

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  • DOI: https://doi.org/10.1007/978-1-59745-357-8_17

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