Chronic Obstructive Pulmonary Disease

Chronic Obstructive Pulmonary Disease

COPD or chronic obstructive pulmonary disease is a progressive disease a type of obstructive lung disease characterized by long-term poor airflow that makes it hard to breathe. "Progressive" means the disease gets worse over time. COPD affects an estimated 24 million individuals in the U.S., and over half of them have symptoms of COPD and do not know it. Early screening can identify COPD before major loss of lung function occurs.

Signs and Symptoms

The most common symptoms of COPD are

sputum production

Wheezing

shortness of breath

productive cough

Causes

Smoking

Air pollution

Occupational exposures

Genetics

Diagnosis

Spirometry

CT  Scan

Chest X-ray

Complete blood count

Management

There is no known cure for COPD, but the symptoms are treatable and its progression can be delayed. The major goals of management are to reduce risk factors, manage stable COPD, prevent and treat acute exacerbations, and manage associated illnesses. The only measures that have been shown to reduce mortality are smoking cessation and supplemental oxygen. Stopping smoking decreases the risk of death by 18%. Other recommendations include influenza vaccination once a year, pneumococcal vaccination once every 5 years, and reduction in exposure to environmental air pollution. In those with advanced disease, palliative care may reduce symptoms, with morphine improving the feelings of shortness of breath. Noninvasive ventilation may be used to support breathing.These are the  key points to manage the COPD:-

Exercise

Bronchodilators

Corticosteroids

Oxygen Therapy

Surgery( lung transplantation)

Prognosis

COPD usually gets gradually worse over time and can ultimately result in death. It is estimated that 3% of all disability is related to COPD. The proportion of disability from COPD globally has decreased from 1990 to 2010 due to improved indoor air quality primarily in Asia. The overall number of years lived with disability from COPD, however, has increased.

The rate at which COPD worsens varies with the presence of factors that predict a poor outcome, including severe airflow obstruction, little ability to exercise, shortness of breath, significantly underweight or overweight, congestive heart failure, continued smoking, and frequent exacerbations. Long-term outcomes in COPD can be estimated using the BODE index which gives a score of zero to ten depending on FEV1, body-mass index, the distance walked in six minutes, and the modified MRC dyspnea scale. Significant weight loss is a bad sign. Results of spirometry are also a good predictor of the future progress of the disease but not as good as the BODE index.