Abstract:
:Important features of both stable and acute exacerbation of chronic obstructive pulmonary disease (COPD) are skeletal muscle weakness and wasting. Limb muscle dysfunction during an exacerbation has been linked to various adverse outcomes, including prolonged hospitalization, readmission, and mortality. The contributing factors leading to muscle dysfunction are similar to those seen in stable COPD: disuse, nutrition/energy balance, hypercapnia, hypoxemia, electrolyte derangements, inflammation, and drugs (i.e., glucocorticoids). These factors may be the trigger for a downstream cascade of local inflammatory changes, pathway process alterations, and structural degradation. Ultimately, the clinical effects can be wide ranging and include reduced limb muscle strength. Current therapies, such as pulmonary/physical rehabilitation, have limited impact because of low participation rates. Recently, novel drugs have been developed in similar disorders, and learnings from these studies can be used as a foundation to facilitate discovery in patients hospitalized with a COPD exacerbation. Nevertheless, investigators should approach this patient population with knowledge of the limitations of each intervention. In this Concise Clinical Review, we provide an overview of acute muscle dysfunction in patients hospitalized with acute exacerbation of COPD and a strategic approach to drug development in this setting.
journal_name
Am J Respir Crit Care Medauthors
Abdulai RM,Jensen TJ,Patel NR,Polkey MI,Jansson P,Celli BR,Rennard SIdoi
10.1164/rccm.201703-0615CIsubject
Has Abstractpub_date
2018-02-15 00:00:00pages
433-449issue
4eissn
1073-449Xissn
1535-4970journal_volume
197pub_type
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journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1164/ajrccm.160.5.9901018
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journal_title:American journal of respiratory and critical care medicine
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journal_title:American journal of respiratory and critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
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pub_type: 临床试验,杂志文章
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更新日期:2012-10-15 00:00:00
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journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章
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更新日期:2007-04-01 00:00:00
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journal_title:American journal of respiratory and critical care medicine
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更新日期:2005-01-15 00:00:00
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更新日期:2000-09-01 00:00:00
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journal_title:American journal of respiratory and critical care medicine
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journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章,随机对照试验
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pub_type: 杂志文章
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更新日期:2010-11-15 00:00:00