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Biomedical subjects

F Smeets

Publications and source records attributed to F Smeets.

10 recordsLinked to original sources
PubMed1994

Prognosis of severely hypoxemic patients receiving long-term oxygen therapy.

Two hundred seventy severely hypoxemic (PaO2 < or = 55 mm Hg: mean +/- SD = 48 +/- 6) COPD patients (232 men) were selected for long-term oxygen therapy (LTOT). They were old (mean = 66 +/- 8 years), with severe airflow limitation (FEV1 = 30 +/- 12 percent of predicted), some CO2 retention (PaCO2 = 47 +/- 9 mm Hg), and compensated respiratory acidosis. Eighteen percent of the patients presented some complicating pleuropulmonary diseases (pleural thickening, sequelae of tuberculosis, etc). Overall survival proportion was poor: 70, 50, and 43 percent at 1, 2, and 3 years, respectively. The Cox model showed that the factors which independently reduced survival were lower CO transfer coefficient, smaller intrathoracic gas volume, more severe bronchial obstruction, the fact that oxygen administration did not increase PaO2 above 65 mm Hg, increasing age, and the presence of chest wall abnormalities. When the patients were divided into three groups according to mortality risk, the mean clinical and functional profile of the high-mortality risk group was consistent with the prevalence of emphysematous lesions. Moreover, the best survivors fitted better into the "bronchitic" type; they showed a higher mean PaCO2, suggesting that some degree of hypoventilation could delay muscular fatigue and improve survival. The difference in the proportion of "emphysematous" and "bronchitic" patients is a possible explanation for the variability of the mortality rate reported in literature.

Acidosis, Respiratory↗
PubMed1993

Place of education in the management of chronic lung disease: role of the educational coordinator.

The aim of patient education is more than just improve compliance to treatment. Teaching the patient to take an active part in the management of his handicap needs special communication skills and involves much more than just giving courses. Unfortunately all medical professionals are not necessarily good educators. As amateurism in patient education is a thing of the past, the role of the Health Education Coordinator in a pulmonary rehabilitation programme becomes essential to the quality of the programme.

Humans↗
PubMed1990

Proposal for a European COPD network.

Over the past few years, pulmonary rehabilitation programs have become more usual in Europe. Even COPD patients on LTOT no longer feel home-bound or grounded. Nevertheless, they experience anxiety when leaving their usual medical environment. The SEP would like to encourage COPD patients to travel by creating a European COPD network. The objectives of this network would be (1) to record all the pulmonary centers in Europe that are involved in pulmonary rehabilitation; (2) to know the availability of oxygen in the different European countries and pulmonary centers; (3) to record those of these centers that would agree to take under supervision COPD patients traveling in their respective area and to provide all technical and medical assistance; (4) to select the most suitable holiday resorts for COPD patients according to ambient temperature, altitude, hotel accommodation, pollution, and possibility for COPD patients to walk around and take excursions; (5) to include oxygen suppliers and medical equipment companies involved in the technical assistance of these COPD patients traveling with all their paraphernalia. Such a European network would enable COPD patients to travel securely, being sure to find medical and technical assistance in all of these "SEP-recommended" places (SEP Guide).

Activities of Daily Living↗
PubMed1990

CO transfer capacity as a determining factor of survival for severe hypoxaemic COPD patients under long-term oxygen therapy.

The transfer capacity for carbon monoxide is a commonly used method in clinical practice but is rarely considered as a prognostic factor for patients under long term oxygen therapy (LTOT). LTOT was applied to 217 stable, severely hypoxaemic (arterial oxygen tension (PaO2 less than 7.3 kPa or 55 mmHg) chronic obstructive pulmonary disease (COPD) patients, according to the usual recommendations. The average survival rate of this series is rather poor: 46% at 24 months. There is nevertheless an important difference between patients with a normal transfer coefficient and those with a decreased one (79% survival at 2 yrs as compared to 37%). On the other hand, the degree of airflow limitation has no prognostic value in the present series of very disabled patients. We can conclude that hypoxaemic COPD patients with a severely decreased transfer coefficient have a poor prognosis, even under LTOT, compared to patients with an equivalent impairment of airflow limitation and hypoxaemia but with a normal CO transfer factor/alveolar ventilation ratio (TLCO/VA).

Aged↗