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Delayed resolution of inflammatory response compared with clinical recovery in patients with acute exacerbations of chronic obstructive pulmonary disease.
MedLine Citation:
PMID:  22758397     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
SUMMARY AT A GLANCE: Systemic inflammatory markers indicated a delay in resolution, as compared with clinical recovery, following acute exacerbations of COPD. However, these markers may be useful adjuncts to routine clinical and laboratory parameters, as monitoring tools during the hospital stay. ABSTRACT: Background and objective:  The temporal profile of inflammatory markers during acute exacerbations of chronic obstructive pulmonary disease (AECOPD) and their relationship to clinical responses are not well characterized. The aim was to assess the changes in levels of inflammatory markers in AECOPD and to correlate these with clinical and laboratory indices of recovery. Methods:   Serum levels of C-reactive protein (CRP), interleukin-6 (IL-6), and fibrinogen were measured in patients with AECOPD, within 24 h of hospitalization and pre-discharge (stable state). Results:   Ninety-seven patients were evaluated (79 males; mean (SD) age, 61.4 (10.3) years). Eighty-eight (90.7%) were current or former smokers, with a median consumption of 15 (0-75) packs/year. The median duration of COPD was 8 (2-25) years and the median duration of current symptoms was 5 (1-30) days. The mean (SD) Charlson index was 1.2 (0.5). Forty-six patients (56.9%) required mechanical ventilation for a median of 5 days (1-34) while in hospital. The median duration of hospital stay was 13 days (1-77). At reassessment before planned discharge, there were significant reductions in CRP, IL-6, and fibrinogen levels compared with baseline, although none of these values returned to the normal range. Changes in IL-6 and fibrinogen levels correlated significantly with the acute physiologic assessment and chronic health evaluation II (APACHE II) score, smoking history, blood pressure, and leucocyte counts. Baseline IL-6 and fibrinogen levels significantly predicted a prolonged duration of mechanical ventilation. Conclusions:   During AECOPD the inflammatory response lags behind clinical and biochemical improvement. Fibrinogen and IL-6 are potentially useful markers for monitoring clinical response following an acute episode. © 2012 The Authors. Respirology © 2012 Asian Pacific Society of Respirology.
Authors:
Anant Mohan; Dharmendra Prasad; Alpana Sharma; Sneh Arora; Randeep Guleria; S K Sharma; R M Pandey
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-7-3
Journal Detail:
Title:  Respirology (Carlton, Vic.)     Volume:  -     ISSN:  1440-1843     ISO Abbreviation:  -     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-7-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9616368     Medline TA:  Respirology     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 The Authors. Respirology © 2012 Asian Pacific Society of Respirology.
Affiliation:
Departments of Pulmonary Medicine and Sleep Disorders, Medicine, Biochemistry, Biostatistics, All India Institute of Medical Sciences, New Delhi, India.
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