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Villa Pineta s.r.l. Ospedale Privato Accreditato “EFFECTIVENESS OF PULMONARY REHABILITATION (PR) IN COPD PATIENTS WITH EMPHYSEMA PHENOTYPE” A. Iattoni – E. Crisafulli A. Iattoni – E. Crisafulli Meeting Dipartimento ad Attività Integrata di Oncologia, Ematologia e Patologie dell’ Apparato Respiratorio Direttore Prof. Leonardo Fabbri MODENA, 16 Luglio 2011

“EFFECTIVENESS OF PULMONARY REHABILITATION (PR) IN COPD PATIENTS WITH EMPHYSEMA PHENOTYPE”

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Meeting Dipartimento ad Attività Integrata di Oncologia, Ematologia e Patologie dell’ Apparato Respiratorio Direttore Prof. Leonardo Fabbri MODENA, 16 Luglio 2011. “EFFECTIVENESS OF PULMONARY REHABILITATION (PR) IN COPD PATIENTS WITH EMPHYSEMA PHENOTYPE”. A. Iattoni – E. Crisafulli. FENOTIPI. - PowerPoint PPT Presentation

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Page 1: “EFFECTIVENESS OF PULMONARY REHABILITATION (PR) IN COPD PATIENTS WITH EMPHYSEMA PHENOTYPE”

Villa Pineta s.r.l. Ospedale Privato Accreditato

“EFFECTIVENESS OF PULMONARY REHABILITATION (PR) IN COPD PATIENTS

WITH EMPHYSEMA PHENOTYPE”

“EFFECTIVENESS OF PULMONARY REHABILITATION (PR) IN COPD PATIENTS

WITH EMPHYSEMA PHENOTYPE”

A. Iattoni – E. CrisafulliA. Iattoni – E. Crisafulli

Meeting Dipartimento ad Attività Integrata di Oncologia, Ematologia e Patologie dell’ Apparato Respiratorio

Direttore Prof. Leonardo FabbriMODENA, 16 Luglio 2011

Page 2: “EFFECTIVENESS OF PULMONARY REHABILITATION (PR) IN COPD PATIENTS WITH EMPHYSEMA PHENOTYPE”

BACKGROUND: FENOTIPI DELLA BPCO

FENOTIPIBRONCHITE

CRONICA

ENFISEMA

Page 3: “EFFECTIVENESS OF PULMONARY REHABILITATION (PR) IN COPD PATIENTS WITH EMPHYSEMA PHENOTYPE”

Adapted from O’Donnell et al. Am J Respir Crit Care Med (2001)Adapted from O’Donnell et al. Am J Respir Crit Care Med (2001)

Ventilation (L/min)Ventilation (L/min)

00

2020

4040

6060

8080

100100

120120

To

tal l

un

g c

apac

ity

(% p

red

)T

ota

l lu

ng

cap

acit

y (%

pre

d)

EELVEELV

IRVIRV

VVTT

HealthHealth

00 1010 2020 3030 4040 5050 6060 7070 8080

ICIC

COPDCOPD

00 1010 2020 3030 4040 5050

ICIC

Ventilation (L/min)Ventilation (L/min)

BACKGROUND: L’IPERINFLAZIONE POLMONARE

Page 4: “EFFECTIVENESS OF PULMONARY REHABILITATION (PR) IN COPD PATIENTS WITH EMPHYSEMA PHENOTYPE”

BACKGROUND: RR RATIONALE

Page 5: “EFFECTIVENESS OF PULMONARY REHABILITATION (PR) IN COPD PATIENTS WITH EMPHYSEMA PHENOTYPE”

BACKGROUND: RR AS PROCESS OF CARE

Page 6: “EFFECTIVENESS OF PULMONARY REHABILITATION (PR) IN COPD PATIENTS WITH EMPHYSEMA PHENOTYPE”

QUALE INTERESSE DI RICERCA ?

1. La RR è efficace per la “malattia” BPCO indipendentemente dal fenotipo clinico

2. I programmi di RR dovrebbero essere “personalizzati” sul paziente secondo le indicazioni degli standard internazionali (ERS/ATS 2006)

3. Non esistono dati in letteratura relativi all’effetto di diversi fenotipi della BPCO sui risultati dei programmi di RR

Page 7: “EFFECTIVENESS OF PULMONARY REHABILITATION (PR) IN COPD PATIENTS WITH EMPHYSEMA PHENOTYPE”

RR IN PAZIENTE CON IPERINFLAZIONE: ANALISI RETROSPETTIVA

Page 8: “EFFECTIVENESS OF PULMONARY REHABILITATION (PR) IN COPD PATIENTS WITH EMPHYSEMA PHENOTYPE”

RR IN PAZIENTE CON IPERINFLAZIONE: ANALISI RETROSPETTIVA

Page 9: “EFFECTIVENESS OF PULMONARY REHABILITATION (PR) IN COPD PATIENTS WITH EMPHYSEMA PHENOTYPE”

RR IN PAZIENTE CON IPERINFLAZIONE: ANALISI RETROSPETTIVA

Page 10: “EFFECTIVENESS OF PULMONARY REHABILITATION (PR) IN COPD PATIENTS WITH EMPHYSEMA PHENOTYPE”

RR IN PAZIENTE CON IPERINFLAZIONE: ANALISI RETROSPETTIVA

Page 11: “EFFECTIVENESS OF PULMONARY REHABILITATION (PR) IN COPD PATIENTS WITH EMPHYSEMA PHENOTYPE”

RR IN PAZIENTE CON IPERINFLAZIONE: ANALISI RETROSPETTIVA

Page 12: “EFFECTIVENESS OF PULMONARY REHABILITATION (PR) IN COPD PATIENTS WITH EMPHYSEMA PHENOTYPE”

RR IN PAZIENTE CON IPERINFLAZIONE: ANALISI RETROSPETTIVA

Page 13: “EFFECTIVENESS OF PULMONARY REHABILITATION (PR) IN COPD PATIENTS WITH EMPHYSEMA PHENOTYPE”

RR IN PAZIENTE CON IPERINFLAZIONE: ANALISI RETROSPETTIVA

● retrospective nature

● other functional indicators (lung diffusion capacity to CO)

● the definition of the LH group, as emphysema-like COPD patients, was exclusively based on the measurement of the residual lung volumes (FRC and RV).

● the functional hypothesis behind the greater change in exercise tolerance, as observed in our LH patients, remains just pure speculation.

STUDY LIMITATIONS

Page 14: “EFFECTIVENESS OF PULMONARY REHABILITATION (PR) IN COPD PATIENTS WITH EMPHYSEMA PHENOTYPE”

OBIETTIVO DELLO STUDIO

To investigate prospectively whether COPD patients with

different disease phenotype (chronic bronchitis vs

pulmonary emphysema) have a different response to PR.

Page 15: “EFFECTIVENESS OF PULMONARY REHABILITATION (PR) IN COPD PATIENTS WITH EMPHYSEMA PHENOTYPE”
Page 16: “EFFECTIVENESS OF PULMONARY REHABILITATION (PR) IN COPD PATIENTS WITH EMPHYSEMA PHENOTYPE”

DISEGNO DELLO STUDIO

PERSPECTIVE

MULTI-CENTRES

OBSERVATIONAL

Page 17: “EFFECTIVENESS OF PULMONARY REHABILITATION (PR) IN COPD PATIENTS WITH EMPHYSEMA PHENOTYPE”

VALUTAZIONE DEL PAZIENTE

Page 18: “EFFECTIVENESS OF PULMONARY REHABILITATION (PR) IN COPD PATIENTS WITH EMPHYSEMA PHENOTYPE”

VALUTAZIONE DEL PAZIENTE

Page 19: “EFFECTIVENESS OF PULMONARY REHABILITATION (PR) IN COPD PATIENTS WITH EMPHYSEMA PHENOTYPE”

VALUTAZIONE DEL PAZIENTE

Page 20: “EFFECTIVENESS OF PULMONARY REHABILITATION (PR) IN COPD PATIENTS WITH EMPHYSEMA PHENOTYPE”

VALUTAZIONE DEL PAZIENTE

Page 21: “EFFECTIVENESS OF PULMONARY REHABILITATION (PR) IN COPD PATIENTS WITH EMPHYSEMA PHENOTYPE”

● APPROVATO DAL COMITATO ETICO

● 350 CASI PREVISTI (50-60 CASI PER OGNI CENTRO PARTECIPANTE)

● 30 CASI RACCOLTI NEL NOSTRO CENTRO

STATO DI AVANZAMENTO