A recent study in JAMA (journal of the American Medical Association) June 16, edition, shows a recent study from Bay State Medical Center in Springfield, Massachusetts on corticosteroids and COPD medication dosages.
Contradiction to the clinical guidelines established, new research has revealed that the broad mass of patients who are hospitalized for serious symptoms of chronic obstructive pulmonary disease (COPD), that were first administered high doses of corticosteroids intravenously, an evaluation signifying that these patients had the same results equal to patients that received the recommended less costly and less invasive treatment of low dosages given orally.
In the United States today, COPD is the fourth leading cause of death. COPD strikes more than six million adults in the United States and causes 32 billion dollars in health care costs. The researchers stated that in 2006, there were 600,000 persons admitted to the hospitals for acute exacerbation of COPD. Which made this one in ten of the leading causes of hospitalizations nationwide. Further stated was that systemic corticosteroids are helpful for patients hospitalized with acute exacerbation of COPD, still the maximum dose and type of administration of medication is still not determined.
Bay State Medical Center, Peter K. Lindenauer M.D., M. S.c., and associates studied the use of corticosteroids in patients hospitalized for acute exacerbation of COPD at 414 U.S. Hospitals during 2006 and 2007. They examined the results of patients who were at first treated low doses of steroids given orally against those who received higher doses given intravenously during the first two days in the hospital. Included in the results the researchers evaluated included a composite measure of treatment failure, described as the start of mechanical ventilation after the second day in hospital, in patient mortality or those being readmitted for acute exacerbation of COPD within thirty days of discharge.
Out of the 79,985 patients, 73,765 patients (92 percent), at the beginning were treated with higher doses of steroids given intravenously, 6,220 (8 percent) were started with lower doses given orally. A total of 1.4 percent of patients who started with steroids given intravenously had died during hospitalization, and 10.9 percent of patients experienced the compost treatment failure, while 1.0 percent of patients treated orally had died during hospitalization and 10.3 experienced the composite result. Patients totaling 1,356 (22 percent) that began treatment with low dose steroids orally later were switched over to intravenous therapy.
Researchers discovered during examination that adjustments for different reasons which included patients, hospital and physician style, the chance of treatments failing within patients given low doses of steroids orally was not greatly different than the patients receiving higher doses of steroids intravenously. Patients that received low doses of steroids orally had to spend less time and hospitals and the cost was lessened.
According to researchers, in the immense factual study they discovered acute comparisons to the recommendations in leading clinical guides. The major portion of patients hospitalized for acute exacerbation COPD where started with high dosages of corticosteroids intravenously. This method does not seem to be linked with any significant clinical benefit and at the same time endangers patients to the chances and hindrance of a intervenous line, likely needless high doses of steroids, larger hospital costs, longer duration of hospitalization.
According to researchers, because of more risks and larger costs linked with high dosage intervenous treatments, possibilities may exist to increase care by advocating considerable utilization of giving low dose steroids orally. Due to the immense number of persons being hospitalized every year in the United States, a clinical trail examining these two avenues to management would be valuable.
Corticosteroids have the potential to treat a variety of conditions including rashes, asthma and lupus. However, they can cause some side effects that could be major issues in the long run. Side effects on the minor side include glaucoma, increased high blood pressure and swelling in lower legs. If used long term you can have cataracts, high blood pressure which can cause diabetes or worsen the condition, loss of calcium to bones which can lead to osteoporosis and fractures along with thinning of skin and bruising easy among numerous other side effects.
Although there is currently no cure available for COPD there are alternative therapies to help reduce the symptoms. Many conventional medicine practitioners do not believe in the use of alternative therapies and would rather patients stick with conventional treatments that can ultimately lead to other serious health problems. Alternative medicine however, does aide in the natural healing process, it treats the cause not only the symptoms and it treats the person as whole including their mind and body.
Here are some alternative therapies that have been used to treat COPD:
Acupuncture and Chinese Medicine have been around for more than 5,000 years. Acupuncture has been proven to reduce shortness of breath, aides in the ability to walk better, improve pulmonary function testing and basically all over improvement of health and well being.
Chinese herbal formulations for COPD have shown increased airway and lung functioning. On such formula is Shengmai San now being used in Chinese hospitals to treat COPD.
Spinal manipulation has been advocated to help COPD patients breathe easier. Unfortunately there are few randomized clinical trails on this area.
There are numerous therapies that can be applied. One is active air therapy which has shown saturating oxygen into a patients blood with levels of 90% or less did rise by three to five percent after a few treatments. Herbal and botanical medicines are also used based on a persons needs. They are totally customized to the patient.
Medical News Today
Institute For Traditional Medicine
UK Pub Med Central