Free Nursing Dissertations - However The Use Of Bronchodilators In Patients Suffering From Chf Has Been
However the use of bronchodilators in patients suffering from CHF has been controversial and if a CHF patient has broncho-spasm and wheezes then a beta 2 selective treatment along with nitrates and diuretics is usually recommended. Within CHF, lack of oxygenation rather than air movement is the primary problem and hypoxemia worsens cardiac function. Dominguez points out that both broncho-constriction and filling up of alveolar sacs impair oxygenation of RBCs and also that of vital organs. Pre-hospital management issues of CHF relate to restoring oxygenation and many agencies use oxygen nitrates, ACE inhibitors and CPAP. The improvement of patient outcomes approach taken by Dominguez accordingly rests on understanding the pathophysiology of respiratory emergencies and their differential diagnosis. Diagnosis of the actual cause of the respiratory problem has been identified as the primary clinical and patient outcome of health care approach related to respiratory emergencies. However we will mention other possible learning outcomes suggesting the very specific ones that we will be concerned with.
In another relevant study Mukhopadhay and Lim (2005) examined the diagnostic and clinical outcomes of consecutive adult inpatients who were admitted to a university hospital and referred to respiratory physicians for breathlessness. All adults referred for breathlessness were enrolled on record for the study and evaluations were done on clinical features and on the utility of routine investigations such as blood tests and radiology. 105 patients were chosen from surgical and cardiology departments of the hospital of whom 49 were men and 56 women and with average age of 66 years. Postoperative acute pulmonary embolism was diagnosed in four patients, chest radiographs helped to make diagnosis in 66 % of patients and computed tomography pulmonary angiogram of thorax was performed in 31 of 34 patients investigated for acute pulmonary embolism. Postoperative patients were tested more for PE than non postoperative patients. The authors concluded from their survey and study of patients with breathing problems that in hospitalized patients referred for breathlessness, respiratory infections were the most common diagnosis and chest radiograph the most useful method for initial investigation of breathlessness. Computed tomography pulmonary angiogram was also identified as preferred method of investigation for acute PE and it was also found that postoperative cases of breathlessness being most apparent, clinicians are more inclined to investigate for PE in postoperative patients.
Falk et al (2005) pointed out from a study on athletes that exercise induced broncho-constriction may involve oxidative stress.
