Overview
Chronic obstructive pulmonary disease (COPD) is a group of
lung conditions that are preventable and treatable. Characteristics of the lung
conditions are enumerated in the Introduction
section.
The estimated global prevalence of COPD is 10.3% based on
the Burden of Obstructive Lung Disease (BOLD) study. Prevalence of the disease
regionally and worldwide can be found in the Epidemiology
section.
COPD involves lung damage and/or alteration of the normal
lung development or the aging process because of complex, cumulative, and
dynamic gene-environment interactions occurring over the individual's lifetime.
Mechanisms regarding these changes are discussed in the Pathophysiology section.
The Risk
Factors section discusses the host factors and exposures that
can contribute to the development of COPD.
Chronic Obstructive Pulmonary Disease_Disease SummaryHistory and Physical Examination
The
Clinical Presentation section
enumerates the presenting symptoms of patients over 40 years of age who have a
suggestive medical history (ie presence of risk factors) that would elicit
diagnosis of COPD.
In the History and Physical Examination sections, factors to elicit and examine are discussed.
Diagnosis
Tests to measure the lung function such as spirometry, pulse
oximetry and arterial blood gas (ABG) measurement, etc are enumerated and
discussed in the Laboratory Tests and
Ancillaries section.
The Imaging section
enumerates the recommended imaging studies used to deduce the diagnosis of
COPD.
The Differential
Diagnosis section enumerates the diseases that may also present
with COPD symptoms, and these should be ruled out.
Management
After the diagnosis of COPD is made, it is recommended to assess
the severity of the disease based on a patient’s symptom or risk to categorize
the patient and identify the management strategies to be done. The Evaluation section elaborates on this
assessment. In this section, the signs
and symptoms of COPD exacerbation are also discussed.
The goals of treatment and therapeutic strategies are
discussed in the Principles of Therapy
section. Some of these goals include prevention and control of symptoms and
improvement of exercise tolerance.
The Pharmacological Therapy
section includes the Global Initiative for Chronic Obstructive
Lung Disease (GOLD) recommendations on the initial treatment of COPD depending
on the patient’s disease category. This section also further discusses the follow-up
treatment options, vaccines and inhalation devices.
Other management options like oxygen therapy, non-invasive
mechanical ventilation, lifestyle modifications, pulmonary rehabilitation and
patient education are discussed in detail in the Nonpharmacological
section.
Surgery is a management option for patients with severe COPD
who are unresponsive to maximal medical treatment. Other indications for
surgery and a list of surgical procedures that can be done are elaborated in
the Surgery section.
Evaluation and management procedures of COPD Exacerbations have a separate section
and are discussed in detail.
Factors to consider in assessing suitability for discharge
and frequency of follow-up and monitoring of patients with COPD are discussed
in the Monitoring section.
