New Guidelines for COPD Management
The American College of Physicians (ACP) has issued clinical recommendations for the management of chronic obstructive pulmonary disease (COPD). The recommendations are published in the November 6, 2007 issue of the Annals of Internal Medicine and include the use of spirometry to diagnose airflow obstruction as well as oxygen therapy in patients with resting hypoxemia.
COPD is defined as a disease state characterized by the presence of airflow obstruction due to chronic bronchitis or emphysema. The airflow obstruction generally is progressive and may be partially reversible. Chronic bronchitis is defined clinically as the presence of a chronic productive cough for 3 months during each of 2 consecutive years with no other known cause. Emphysema is defined as an abnormal, permanent enlargement of the air sacs, or alveoli, of the lung accompanied by destruction of their walls and without obvious excess fibrous connective tissue. Unlike chronic bronchitis, which is defined in clinical terms, emphysema is defined in terms of anatomic pathology. Cigarette smoking is the most common cause of COPD, and most people with COPD are smokers or former smokers. In addition to cigarette smoking, inhalation of other types of lung irritants, such as pollution, dust or chemicals, over a long period of time may also cause or contribute to COPD. According to Amir Qaseem, MD, PhD, MHA, from the ACP in Philadelphia, Pennsylvania, and colleagues from the ACP Clinical Efficacy Assessment Subcommittee, "the symptoms of COPD range from chronic cough, sputum production, and wheezing to more severe symptoms, such as dyspnea, poor exercise tolerance, and signs of symptoms of right-sided heart failure. In the United States, COPD affects more than 5% of the adult population and is the 4th leading cause of death and the 12th leading cause of morbidity."
Please refer to the American Thoracic Society and the American Lung Association for useful general information about COPD as well as The Cleveland Clinic Health Information Center for nutritional guidelines for people with COPD. To view the ACP recommendations referenced above, please click here.
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