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Chronic obstructive pulmonary disease management: the evidence base.

Publication ,  Journal Article
MacIntyre, NR
Published in: Respir Care
November 2001

In long-term management of stable chronic obstructive pulmonary disease (COPD), a number of medications improve pulmonary function test results. The long-term clinical benefits of those drugs would seem intuitive, but there is very little strong evidence that long-term outcomes in COPD are substantially affected by those drugs. Nevertheless, symptom improvement such as dyspnea reduction is certainly strong reason to use those agents. The 2 most compelling bodies of evidence in stable COPD are for oxygen therapy in the chronically hypoxemic patient and pulmonary rehabilitation to improve exercise tolerance and dyspnea. Inhaled corticosteroids also appear to be useful in patients at risk for frequent exacerbations. In acute exacerbations, the rationale for therapy comes in part from the large body of literature regarding acute asthma therapy. Bronchodilator therapy and corticosteroids both seem to reduce the severity and the duration of exacerbations. Moreover, routine antibiotic use seems beneficial, and the role of noninvasive positive-pressure ventilation with patients suffering impending respiratory failure from acute COPD exacerbations is well supported by the literature.

Duke Scholars

Published In

Respir Care

ISSN

0020-1324

Publication Date

November 2001

Volume

46

Issue

11

Start / End Page

1294 / 1303

Location

United States

Related Subject Headings

  • Respiratory System
  • Pulmonary Disease, Chronic Obstructive
  • Oxygen
  • Humans
  • Evidence-Based Medicine
  • Bronchodilator Agents
  • Adrenal Cortex Hormones
  • Acute Disease
  • 3202 Clinical sciences
  • 3201 Cardiovascular medicine and haematology
 

Citation

APA
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ICMJE
MLA
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MacIntyre, N. R. (2001). Chronic obstructive pulmonary disease management: the evidence base. Respir Care, 46(11), 1294–1303.
MacIntyre, N. R. “Chronic obstructive pulmonary disease management: the evidence base.Respir Care 46, no. 11 (November 2001): 1294–1303.
MacIntyre NR. Chronic obstructive pulmonary disease management: the evidence base. Respir Care. 2001 Nov;46(11):1294–303.
MacIntyre, N. R. “Chronic obstructive pulmonary disease management: the evidence base.Respir Care, vol. 46, no. 11, Nov. 2001, pp. 1294–303.
MacIntyre NR. Chronic obstructive pulmonary disease management: the evidence base. Respir Care. 2001 Nov;46(11):1294–1303.

Published In

Respir Care

ISSN

0020-1324

Publication Date

November 2001

Volume

46

Issue

11

Start / End Page

1294 / 1303

Location

United States

Related Subject Headings

  • Respiratory System
  • Pulmonary Disease, Chronic Obstructive
  • Oxygen
  • Humans
  • Evidence-Based Medicine
  • Bronchodilator Agents
  • Adrenal Cortex Hormones
  • Acute Disease
  • 3202 Clinical sciences
  • 3201 Cardiovascular medicine and haematology