From the Guidelines
Lung health is crucial for overall well-being, and conditions such as chronic obstructive pulmonary disease (COPD) can significantly impact morbidity, mortality, and quality of life. The diagnosis of COPD is first suspected when a patient complains of symptoms such as cough, sputum production, dyspnea, or recurrent lower respiratory infections, and reports risk factors for the disease, such as exposure to cigarette smoke or environmental or occupational pollutants 1.
Key Points to Consider
- The presence of symptoms can be extremely variable in patients with COPD, and a firm diagnosis can only be made by objective measurement of airways obstruction with spirometric tests 1.
- Chest radiography is generally performed during the initial diagnostic evaluation of patients with suspected COPD to exclude other diseases that may cause similar symptoms and signs, and to establish the presence of concomitant respiratory diseases 1.
- Computed tomography (CT) can estimate the degree of emphysema and its distribution, and identify bronchial wall thickening and gas trapping, which can help differentiate between structural abnormalities that cause airflow limitation and detect both pulmonary and nonpulmonary comorbidities 1.
Importance of Early Detection and Management
Early detection and management of COPD are critical to improve outcomes and reduce the risk of complications, such as lung cancer, which is increased among patients with COPD, but is inversely related to the degree of airflow obstruction 1. Therefore, it is essential to prioritize lung health through avoiding smoking, minimizing exposure to pollutants, and maintaining overall health, and to seek medical attention if symptoms persist or worsen over time.
Diagnostic Evaluation
The diagnostic evaluation of patients with suspected COPD should include a thorough medical history, physical examination, spirometric tests, and chest radiography, and may also involve CT scanning to estimate the degree of emphysema and its distribution, and to identify bronchial wall thickening and gas trapping 1.
Management and Treatment
The management and treatment of COPD should be individualized based on the severity of the disease, the presence of comorbidities, and the patient's overall health status, and may involve pharmacological and non-pharmacological interventions, such as bronchodilators, pulmonary rehabilitation, and lifestyle modifications 1. The goal of treatment is to improve symptoms, slow disease progression, and enhance quality of life, while minimizing the risk of complications and mortality.
From the Research
Lung Function and Rehabilitation
- Pulmonary rehabilitation (PR) is a core component in the management of patients with chronic obstructive pulmonary disease (COPD) 2, 3
- PR includes exercise training, self-management education, and psychosocial and nutritional intervention 3
- The goal of PR is to achieve the maximal level of independence, autonomy, and functioning of the patient 2
Treatment and Management
- Inhaled bronchodilators and corticosteroids are used to treat asthma-COPD overlap 4
- Long-acting beta2-agonist (LABA) is associated with decreased risk of myocardial infarction, and the combination therapy of inhaled corticosteroid (ICS)/LABA appears to reduce the risk of death or hospitalization 4
- Different ICS/LABA combinations have varying risk and benefit profiles in patients with COPD 5
Assessment and Diagnosis
- A full respiratory assessment is an essential skill for all nurses, including initial assessment, history taking, inspection, palpation, percussion, auscultation, and further investigations 6
- Clinical examination of the patient involves inspection, palpation, percussion, and auscultation to gather information about the patient's condition 6