Non-Invasive Ventilation in Severe Acute Respiratory Failure (ARF) Literature review

Non-Invasive Ventilation in Severe Acute Respiratory Failure (ARF) secondary to an Acute Exacerbation of Chronic Obstructive Pul - Literature review Example Figure 3: Kaplan-Meier plot showing cumulative survival following the initiation of NIV (Chung et al., 2010) 18 Introduction Chronic obstructive pulmonary disease (COPD) is among the leading global causes of chronic morbidity and mortality, being listed as fourth leading cause of death worldwide (British Lung Foundation, 2007). It accounts for approximately 30,000 deaths each year in the United Kingdom (UK) , with more than 90% of these occurring in the over 65 age group "in 2004" (Healthcare Commission, 2006). The prevalence of the disease is expected to rise in coming decades and it is projected to be the third leading cause of death worldwide by 2020 (Murray and Lopez 1997). A disorder with chronic airflow limitation, the definition of COPD now gaining acceptance defines COPD as â€Å"a disease state characterized by airflow limitation that is not fully reversible. The airflow limitation is usually both progressive and associated with an abnormal; inflammatory response of the lun gs to noxious particles or gases† (GOLD, 2010). Three general types of lesions are associated with COPD: emphysema, small airways inflammation and fibrosis, and mucus gland hyperplasia (Senior & Anthonisen, 1998). Excessive decline of lung function in patients with COPD leading to hospitalisation and death due to COPD is associated with presence of chronic mucus hypersecretion (Vestbo & Lang, 1996). Tobacco use is definitely the major risk factor for COPD defined by pack-year or cumulative dose, besides other risk factors such as age (Blanchette et al., 2011), familial tendencies, childhood respiratory diseases, (Senior & Anthonisen, 1998) and occupational exposure (Tomas, 2011; Blanc et al., 2009) Up to 20% of COPD patients admitted to hospital present with respiratory acidosis (Plant, 2000), characterised by deterioration in gas exchange, along with tachypnoea, dyspnoea, and crepitation (Brochard, 2000); as was observed in the case studied by the author. Studies have recomme nded the use of Non-invasive ventilation (NIV) in such cases of exacerbations of COPD (Dikensoy et al., 2002). However, there are controversies to selection of patients who may be considered eligible and may actually benefit from NIV due to methodological factors. Patients with exacerbations of COPD who are not likely to respond to conventional support therapy and those in which NIV can be used for averting the needs of invasive mechanical ventilation can be selected for administration of NIV (Garpestad et al., 2007). Besides severity of exacerbations and respiratory acidosis, several other factors such as individual characteristics, timing of intervention, skill of operating

Viewing Disability Binary vs. Continuum Coursework

Viewing Disability Binary vs. Continuum - Coursework Example In this regard, viewing disability in a binary sense would be unfair as persons who have suffered disabilities because of one reason or the other. Therefore, it should be seen as a continuum and hence set as a bio-psychosocial representation incorporating both social and medical forms of disability. A binary view of disability would further hinder an interactive and accommodative situation of the complexities of his or her impairment or disability and the environment. Viewing the disability as a continuum would afford the individual the chance to see all aspects of their body functioning. It would also open for them the opportunity to exploit their capacity and partake in various activities. On the other hand, a binary view of disability would not consider the interrelation between the resultant interaction of contextual factors and an individuals health condition where disability should be regarded as an injury. It should also be measured in the context of the limitations in the activities an individual can perform their capacity and their performance at society levels hence. Schelly, D. (2008). Problems associated with choice and quality of life for an individual with intellectual disability: a personal assistants reflexive ethnography. Disability & Society, 23(7), 719-732.