Chronic Obstructive Pulmonary Disease Disease Summary

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 Summary

History 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.

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.