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Paper of the day - give pulmonary rehabilition in severe COPD

Patients with chronic respiratory failure, the most severe form of chronic obstructive pulmonary disease, should be given prescribed pulmonary rehabilitation because it will be as beneficial as it is for patients with less severe COPD, says an Italian study.

Pulmonary rehabilitation is known to improve lung function in patients with the least severe forms of COPD, but until now its effectiveness in the more severe chronic respiratory failure has been less well-established.

The researchers assessed the effect of pulmonary rehabilitation on lung function, arterial gases, walking, dyspnoea and quality of life in 1047 consecutive patients with COPD, 327 of whom had CRF. Improvements across all parameters were similar in regardless of severity of COPD.

The pulmonary rehabilitation programme included educational support, exercise training, and nutritional and psychological counselling.

The authors concluded: ‘This study, featuring the largest cohort so far reported in the literature, shows that pulmonary rehabilitation is equally effective in the more severe COPD patients, i.e. those with CRF, and supports the prescription of pulmonary rehabilitation also in these patients.'

Respiratory Medicine 2007; 101; 2447-2453

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