Prevalence and Treatment of Pulmonary Diseases - Week 11b - Charles Sturt University 2024

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Warning This material has been produced and communicated to you by or on behalf of Charles Sturt University in accordance with section 113P of the copyright act (Act). The material in this communication may by subject to copyright under the act. Any further reproduction or communication of this material by you may be the subject of copyright protection under this act. Do not remove this notice 1  Week 11 lecture 2 Prevalence of Pulmonary Conditions in Australia  Asthma 467 deaths in Australia related to asthma in 2022 (299 female/168 male) 2.8 million (11%) Australians have asthma 2022 (10.2 % 2011-12) Females had higher rates of asthma than males in (12.2% compared with 9.4%), but 0-14 yrs boys higher than girls (10.1% compared to 6.2%) The prevalence of asthma was higher for people living in disadvantaged areas (13.2% compared to 10.2%) Living with a disability higher (17.0% compared to 8.0%) 16% of First Nations people (down from 18% 2012-13) All adults 18 yrs and over with asthma: 1 in 7 daily smokers, 1 in 3 were ex-smokers. Adults with asthma less likely to never smoked than those without any selected long-term health conditions  COPD In 2022 2.5% of Australians had COPD (steady in the last decade) Prevalence being similar between males and females (2.4% and 2.6%) 7.0% of people aged 65 years and over had COPD 18+ yrs who were current daily smokers were more likely to have COPD than either ex-smokers (8.1% compared to 4.4%) or those who have never smoked (8.1% compared to 1.6%) Of all people with COPD in 2022, 86.6% had two or more chronic conditions. 1 in 10 (9.3%) adults who experienced severe or very severe bodily pain in the 4-weeks prior to interview had COPD Diagnostic Procedures  Spirometry Measurement of pulmonary volumes and rate of expired airflow Useful for diagnosing lung diseases & monitor improvement or deterioration Spirometric tests Vital capacity (VC) – Maximal volume of air that can be expired after maximal inspiration Forced expiratory volume in 1sec (FEV1) – Volume of air expired during 1 second during maximal expiration FEV1/FVC ratio – ≥80% is normal for healthy individuals Key differences between an obstructive and restrictive – Obstructive = both FEV1 and FEV1% are decreased – Restrictive = FEV1 is decreased but the FEV1% in normal or sometimes increased  Arterial Blood Gases Determine pH levels, bicarbonate (HCO3-) and partial pressures of O2 and CO2 in arterial blood Contribute to diagnosis and determine need for oxygen therapy  Compensatory processes A primary process is followed by a compensatory process Primary respiratory acidosis (high PCO2)/ acidemia: compensatory process = metabolic alkalosis (rise in the serum bicarbonate). Primary respiratory alkalosis (low PCO2)/ alkalemia: compensatory process = metabolic acidosis (decrease in the serum bicarbonate) Primary metabolic acidosis (low bicarbonate)/ academia; compensatory process = respiratory alkalosis (low PCO2). Primary metabolic alkalosis (high bicarbonate)/ alkalemia: compensatory = respiratory acidosis (high PCO2) 11  Imaging Chest roentgenogram (X-ray) often used to differentiate between emphysema and chronic bronchitis Emphysema – large lung volumes, hyperinflation, flattened diaphragm and vascular weakening Hyperinflation at times present in clients with asthma Computed tomography (CT) scan – greater sensitivity  Bronchoscopy Insertion of a bronchoscope through nose or mouth into the lungs to identify pathologies, remove foreign objects or obtain a sample Typically performed after a CT or chest X-ray Bronchial provocation test Assist in asthma diagnosis to assess sensitivity of the airways Involves inhalation of methacholine following by spirometry assessments  Sweat chloride Used for diagnosis of cystic fibrosis – considered gold standard Higher chlorine concentrations in clients with CF Due to mutation in two copies of the CFTR gene, allowing excess chlorine into the extracellular spaces Gene Mutation testing – determine if someone is a CF carrier or establish diagnosis Nutritional Considerations  COPD Malnutrition or nutritional depletion may be an issues for up to 25% COPD clients Increased prevalence with severity of disease Malnutrition and associated weight loss has identified as a predictor of mortality Causes for malnutrition are not well known Reduced energy intake Increased caloric demand (higher BMR) Affect diaphragm (contractile force) Collins et al. 2019. Nutritional support in COPD: an evidence based update (JTD) 16 Cystic Fibrosis Undernutrition and associated failure for weight gain and linear growth is common among CF clients Degree of malnutrition correlates with severity of pulmonary diseases and survival rates Energy intake recommendations are higher than healthy population (120- 150% recommendations) Energy imbalances can be attributable to poor digestion and absorption (associated with pancreatic failure) Supplementation may be required and higher fat consumption – clients need to be consulting with a dietician!!! 18 Watch ✓ Week 11 Lecture Engage ✓ Week 11 Tutorial READ ✓ Ehrman Chapters 19, 20, 21 ✓ ACSM Chapter 25 19