COPD

• Chronic Obstructive Pulmonary Disease

  Airflow obstruction that is not fully reversible. It's characterised by persistent respiratory symptoms and airflow limitation due to alveolar abnormalities usually caused by exposure to noxious particles or gases.
• Risks


  • Smoking
  • Noxious gas exposure
  • Pollution
  • Occupational dusts and chemicals
  • Reoccurring infections
  • Genetic predisposition
  • Reduced lung growth
  • Airway hyper-responsiveness
• In high-middle income countries, tobacco smoke is the biggest risk for COPD
• In low-income counties, exposure to indoor air pollution (biomass and coal fuels for cooking and heating) is the biggest risk for COPD
• Symptoms

  • Chronic cough
  • Sputum production
  • Dyspnoea
  • A history of risks
• Diagnostics


  • Spirometry
  • FEV is less than or equal to 80%
  • FEV1/FVC is less than 0.7
  • Examination
• Management

  • Smoking reduction
  • Inhaler therapy
  • Oxygen therapy
  • Pulmonary rehab
  • Vaccines
  • Sputum clearance
  • Nutritional factors
  • Advice and educate
• Aims of management


  • Prevent disease progression
  • Relieve symptoms
  • Improve exercise tolerance
  • Improve health status
  • Prevent and treat complications
  • Prevent and treat exacerbations
  • Reduce mortality
• Chronic bronchitis

  • Inflammation and mucous hypersecretion in the large airways
• Emphysema


  • Destruction of the lung parenchyma (respiratory bronchioles)
• Small airway disease


  • Inflation and fibrosis of small airways
• Other complications


  • Weight loss
  • Skeletal muscle dysfunction
  • Cardiac dysfunction
• Assessment of severity

  
• Spirometry is used to assess the degree of obstruction, but it does not reflect the patient's functional capacity or quality of life.
• Exercise testing can be used to evaluate functional capacity and identify patients at risk of adverse events during rehabilitation programs.
• Arterial blood gas analysis may be necessary if there are concerns about hypoxemia or hypercapnia.