8(th) International conference on management and rehabilitation of chronic respiratory failure: the long summaries – Part 3

Ambrosino, Nicolino; Casaburi, Richard; Chetta, Alfredo; Clini, Enrico; Donner, Claudio F.; Dreher, Michael; Goldstein, Roger; Jubran, Amal; Nici, Linda; Owen, Caroline A.; Rochester, Carolyn; Tobin, Martin J.; Vagheggini, Guido; Vitacca, Michele; ZuWallack, Richard

In the USA, non-oncological respiratory causes account for 8 % of all deaths and 9.6 % of deaths in individuals over age 65 years; of these 56 % are from COPD [111] . The COPD time course is characterized by a progressive worsening of dyspnoea, reduced effort tolerance, and more frequent exacerbations and hospitalizations [36] . In COPD, oxygen therapy and mechanical ventilation (MV) improve survival and morbidity in acute-on-chronic respiratory failure [36] . The downhill trajectory in COPD patients is variable and not as predictable as that of other chronic diseases [36] . In general, the course of COPD is that of progressive long-term disability, with periodic exacerbations and unpredictable timing of death which characterize dying with chronic multiorgan failure [36] . In a provocative paper, Curtis et al. [36] proposed that, after a serious analysis of the conditions and clinical status, we would define a patient needing palliative care when he/she has a low chance of recovery, poor rehabilitation potential, and high organizational complexity and instrumental requirements.