From the Guidelines
Lung health is crucial for overall well-being, and maintaining healthy lungs can be achieved by avoiding smoking, minimizing exposure to air pollutants, exercising regularly, practicing deep breathing, and getting vaccinated against respiratory infections like pneumonia and influenza. When considering lung health, it's essential to understand the importance of proper diagnosis and management of respiratory diseases, such as Chronic Obstructive Pulmonary Disease (COPD) 1. According to the American Thoracic Society and European Respiratory Society, the diagnosis of COPD is first suspected when a patient complains of symptoms like cough, sputum production, dyspnea, or recurrent lower respiratory infections 1.
Key Indicators for Lung Health
Some key indicators for considering a diagnosis of COPD include:
- Dyspnea that is progressive over time, characteristically worse with exercise, and persistent
- Chronic cough, which may be intermittent and unproductive
- Chronic sputum production, with any pattern
- Recurrent lower respiratory tract infections
- History of risk factors, such as tobacco smoke, smoke from home cooking and heating fuels, occupational dusts, vapors, fumes, gases, and other chemicals 1
Diagnostic Evaluation
The diagnostic evaluation of patients with suspected COPD should include a physical examination, chest radiography, and spirometry 1. Spirometry is required to establish a diagnosis of COPD, and it's essential to use the fixed ratio over the lower limit of normal (LLN) for diagnostic simplicity and consistency 1. Computed tomography (CT) scans can also be used to estimate the degree of emphysema and its distribution, identify bronchial wall thickening and gas trapping, and detect pulmonary and non-pulmonary comorbidities 1.
Maintaining Lung Health
To maintain healthy lungs, it's crucial to:
- Avoid smoking and minimize exposure to air pollutants
- Exercise regularly and practice deep breathing
- Get vaccinated against respiratory infections like pneumonia and influenza
- Follow a healthy diet and maintain a healthy weight
- Manage stress and get enough sleep 1
From the Research
Lung Conditions and Treatment
- Asthma is associated with a three times higher risk of being hospitalized for pneumonia, as found in a study published in 2.
- The use of inhaled corticosteroids (ICS) in asthmatics may increase the risk of pneumonia, with fluticasone propionate showing a significant association with an increased risk of pneumonia 2.
- Chronic obstructive pulmonary disease (COPD) patients may benefit from azithromycin therapy to reduce acute exacerbations, as shown in studies published in 3 and 4.
Treatment Options
- Azithromycin has been found to be effective in reducing the number of exacerbations in COPD patients, particularly those with frequent exacerbations and blood eosinophilia over 2% 3.
- Long-term azithromycin therapy has been shown to reduce exacerbation numbers in severe COPD patients and benefits may persist beyond one year 4.
- Home oxygen therapy is recommended for adults with chronic lung disease, including COPD and interstitial lung disease (ILD), with severe chronic resting hypoxemia 5.
Pneumonia Evaluation and Treatment
- Pneumonia is a common cause of respiratory infection, accounting for more than 800,000 hospitalizations in the United States annually 6.
- Presenting symptoms of pneumonia typically include cough, pleuritic chest pain, fever, fatigue, and loss of appetite, although children and the elderly may have different presenting features 6.
- Knowledge of local bacterial pathogens and their antibiotic susceptibility and resistance profiles is key for effective pharmacologic selection and treatment of pneumonia 6.