Early stage COPD and osteopathy Osteopathybooks

Early stage COPD and osteopathy

COPD and Osteopathy

Don’t think that COPD only is a condition of very ill patients. It must be clear for osteopaths that COPD in the early stage is often not diagnosed as such.

Therefore, it is important to evaluate the patients’ situation (at least from the age of 40 years on) concerning oxygenation.

Early stage of COPD:

• Loss of alveoli started (destruction).
• Surface area for diffusion decreases.
• The volume of gas that can cross the alveolar membrane diminishes.

Knowing that the diffusion coefficient for CO2 is 20 times that of O2, the patient will have problems with oxygen before he/she has problems with CO2. Hypoxia will develop before hypercapnia (CO2 retention).

The hypoxia will stimulate the peripheral chemoreceptors to increase ventilation.

When the oxygen consumption stays the same, the PaCO2 will fall (hypocapnia) and the central chemoreceptors will inhibit the respiratory centers in the medulla oblongata.

This means that the patient who needs more ventilation to maintain the oxygen level in the blood but the drive to breath is reduced. The oxygen levels will decrease.

In such a case, the brain will reset the central chemoreceptors. They will accept a PaCO2 of 30 as normal (normally this is 40 mmHg). Actually, the composition of the CSF will compensate the altered CO2 (and therefore the pH).

Because of the lower PaCO2 in the patients’ blood, not only is the patients’ blood more basic, but his/her CSF is as well. In order to reset the central chemoreceptors, we are going to bring the pH of the CSF back to the normal value (CSF has a slightly more acidic pH than blood under normal conditions - about 7.33).


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