| Author | 5 Posts |
Justice
Forum Fanatic
Topics: 117
Posts: 2,324
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Hey colleagues,
what is the limit of blood desaturation for O2 in patient with COPD when the steroids are indicated?
Thank you...
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| peraspera
Forum Elite
Topics: 38
Posts: 233
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According to Harrison's principles of Intern. med;
In Stable Phase COPD the chronic use of oral glucocort. for treatment of COPD is not recommended bs of an unfavorable benefit/ risk ratio.
Glucocorticoigs are recommended for Acute Exacerbations : the presence of hypercabia, defined as aP CO2> 45mm Hg, has important implications for treatment #1.Glucocort.,Oxygen, A/biot, Bronchodilat.
It's what Harrison's book has. 
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| Justice
Forum Fanatic
Topics: 117
Posts: 2,324
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So, saturation of less then 85% is not indication?
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| peraspera
Forum Elite
Topics: 38
Posts: 233
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In patients with more advanced disease (usually classified as an FEV1 <50% pred) there is evidence that the number of exacerbations per year and the rate of deterioration in health status can be reduced by inhaled corticosteroids in COPD. We will give steroids according to Pulmonary Function Testing (FEV1/FVC ratio).Because this ratio is best predictor of survival.Steroids for exacerbations only.
Respiratory failure can be manifest either as HYPOXEMIA ( PO2< 60mmHg at sea level),i.e inadequate blood oxygenation ; HYPERCARBIA ( PCO2 > 45 mmHg)i.e excess of circulating carbon diox. or a combination of both types of gas exchange abnormalities.
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| radonc
Forum Senior
Topics: 10
Posts: 180
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Corticosteroid - inhaled only - may be indicated in moderate/severe COPD when there is a significant improvement following a 2-week-croticosteroid trial. The trial is given as 30mg/day for 2 weeks, with pulmonary functions measured before and after the trial. The aim of this trial is to assess obstruction reversibility, which are present in some pts with COPD.
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