Chronic Obstructive Pulmonary Disease Exacerbation (COPD exacerbation). Chronic obstructive pulmonary disease with (acute) exacerbation
Conditions
Interventions
Intervention 1: Intervention Group: In addition to standard treatment, they receive ketamine nebulizer with a dose of 0.5 mg per weight and a maximum of 25 mg. After 20 minutes, if the symptoms do not
Sponsors
Yazd University of Medical Sciences
Eligibility
Sex/Gender
All
Age
18 Years to 60 Years
Inclusion criteria
Inclusion criteria: Patients aged 16 to 60 years with moderate to severe COPD who refer to the emergency room of Shahid Rahmonun and Shahid Sadoughi hospitals and do not meet the exclusion criteria.
Exclusion criteria
Exclusion criteria: Patients under 16 and over 60 years old Heart, kidney, liver failure Patients with heart diseases such as arrhythmia, ischemic heart diseases, etc. Oral fever above 38.3 degrees Celsius Low blood pressure (diastolic blood pressure less than 90 mm Hg) or high blood pressure (systolic blood pressure more than 180 mm Hg) glaucoma Decreased level of consciousness, brain tumor, suspicion of increased intracranial pressure (ICP) for any reason, psychosis, history of seizures and other brain disorders... Suspicion of other respiratory diseases such as pneumonia, pneumothorax, pulmonary embolism, pulmonary edema, etc. Inability to use peak expiratory flow meter Severe respiratory distress requiring intubation or NIV Pregnancy Known allergy to ketamine.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Peak expiratory flow rate (PEFR) improvement. Timepoint: Upon arrival, 60 minutes later, 4 hours later. Method of measurement: By the peak flow monitor, after taking a deep breath, the patient blows into the device 3 times with maximum speed and power, and the best one is selected for study.;Increase Arterial O2 Saturation(SaO2). Timepoint: Upon arrival, 20, 40, 60 ,90 , 120 minutes later, 4 hours later. Method of measurement: By pulse oximeter.;Decrease pulse rate and respiratory rate. Timepoint: Upon arrival, 20, 40, 60 ,90 , 120 minutes later, 4 hours later. Method of measurement: By monitoring device.;Improvement of dyspnea severity score. Timepoint: Upon arrival, 20, 40, 60 ,90 , 120 minutes later, 4 hours later. Method of measurement: Based on the modified Borg dyspnea scale, the patient scored the severity of her/his dyspnea from 0 to 10. | — |
Secondary
| Measure | Time frame |
|---|---|
| The need for hospitalization. Timepoint: On arrival, 60 minutes and 4 hours later. Method of measurement: Based on the clinical symptoms and severity of the patient's dyspnea.;The need for a second dose of the drug. Timepoint: On arrival, 60 minutes and 4 hours later. Method of measurement: Based on the clinical symptoms and severity of the patient's dyspnea.;The extent of the need to start rescue medication. Timepoint: On arrival, 60 minutes and 4 hours later. Method of measurement: Based on the clinical symptoms and severity of the patient's dyspnea. | — |
Countries
Iran (Islamic Republic of)
Contacts
Public ContactGolnaz Samadzadeh Yazdi
Yazd University of Medical Sciences
Outcome results
None listed