Chronic Obstructive Pulmonary Disease

Chronic obstructive pulmonary disease (COPD) is characterized primarily by irreversible lung damage resulting in reduced airflow. Approximately 16 million Americans have the disease, which is the fourth leading cause of death in the United States. Current practice is guided by staging guidelines for both diagnosis and treatment. Pharmacotherapy, particularly with the brochodilators ipratropium and β2-agonists, remains the cornerstone of treatment. Corticosteroids are recommended for patients who experience frequent acute exacerbations accompanied by reversible symptoms. Noninvasive ventilation therapy may be used for patients experiencing acute exacerbations of COPD. Oxygen therapy should be started in patients with hypoxemia. For qualified candidates with very severe COPD, lung volume reduction surgery may be appropriate. Pulmonary rehabilitation therapy of varying levels is recommended for all patients with COPD. Patient education is an important component of any rehabilitation program, particularly instruction on drug management. Several treatment strategies that may dramatically affect the management of COPD are in development. Prevention remains the most powerful approach in reversing climbing prevalence rates.

Duke Scholars

Author Neil Ross MacIntyre Jr. Medicine, Pulmonary, Allergy, and Critical Care Medicine