What are the benefits of cortisone?

Cortisol is known to many people as the “stress hormone” of the body. Cortisol has various functions, all of which are aimed at enabling people to function even under stress. Among other things, cortisol makes us awake, suppresses energy-consuming inflammatory reactions and promotes degradation processes that lead to the release of energy.

Cortisone is the transport form of the hormone cortisol. When cortisone is applied locally, the inflammatory reaction taking place there is suppressed by the body’s own signaling pathways. In COPD, constant irritation of the bronchial tubes, usually through smoking, causes the mucous membrane to become inflamed and thus swell. Cortisone inhibits this inflammation and thus causes the mucosa to swell and the reduction of mucus, which together leads to an improvement in the symptoms. However, since cortisone, by inhibiting the body’s own defence system, also favours local infections, which can have a severe course especially in COPD patients, it is only added at the higher levels of COPD stage therapy.

When do you need oxygen?

At a certain stage of COPD, it can become very difficult for the patient to breathe in sufficiently to saturate the blood with oxygen. The oxygen saturation of the blood can be measured. It is usually 95%-100% in healthy people.

If it falls below 90% in a COPD patient, treatment with oxygen can be considered. The decision also depends on the subjective perception of the patient. Once oxygen therapy has been started, it is often the case that the (psychological) need for oxygen becomes greater and greater and the patient can no longer escape it so easily.

In COPD, oxygen therapy is also only useful up to an amount of one liter/minute. Higher doses are even dangerous over a longer period. In a healthy person, the respiratory drive is controlled by the amount of CO2 in the blood.

However, since COPD patients cannot breathe CO2 well, the body gets used to an increased amount in the blood. The control of inhalation and exhalation is therefore made dependent on the oxygen saturation of the blood. If the oxygen content in the blood is increased by excessive oxygen therapy, the respiratory drive is massively reduced and a dangerous respiratory depression can occur.