1.2 Chronic Obstructive Pulmonary Disease (COPD)
1.2.1 What is COPD?
COPD is a chronic inflammation of the airways leading to fixed airflow obstruction and restricted gas exchange. The term COPD includes two basic respiratory pathologies: chronic bronchitis and emphysema (GOLD, 2006) that are described below. The condition is not reversible and may progressively worsen with time (NICE, 2010).
Chronic bronchitis: is the narrowing of the bronchi and bronchioles due to thickening of the airway walls and enlargement of mucus glands from chronic inflammation (Hogg, 2008). COPD caused by chronic bronchitis is characterized by excessive mucus production and expectoration, with mucus plugging contributing to obstruction of the bronchial tree,
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The severity of COPD is clinically categorised into four stages by the Global initiative for Obstructive Lung Disease (GOLD), based on the predicted percentage (%) of normal FEV1, in subjects presenting with < 0.7 FEV1/FVC post-bronchodilator ratio (GOLD,2006) (Table 1.1). Introduction
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Table 1.1: GOLD stages of COPD severity GOLD 2016
All the stages had FEV1/FVC ratio <0.7, post-bronchodilator
Although a useful guide, severity assessment based on FEV1 alone is considered a weak marker for predicting morbidity and mortality as there is a poor association between extent of airflow obstruction and common COPD symptoms like breathlessness, exercise capacity and health status, (Celli et al., 2004). Several other measures such as the BODE (body mass index (B), airflow obstruction (O), dyspnoea (D), exercise capacity (E)) and ADO (age (A), dyspnoea (D) and airflow obstruction (O) indices have been developed and are superior for accurately defining disease severity (Puhan et al., 2009).
1.2.3 COPD symptoms
COPD patients experience shortness of breath and suffer from tightness in their chest, which leads to wheezing and laboured breathing. Damage to the lung parenchyma and recoiling mechanisms causes poor oxygenation of blood and accumulation of carbon dioxide (GOLD, 2006). COPD is characterized by persistent cough, sputum production due to excess mucus secretion by damaged airways and impaired ciliary mucus clearance. Expectoration of
Chronic bronchitis, emphysema and chronic asthma are the main three conditions that make up COPD. Emphysema causes
R.W. appears with progressive difficulty getting his breath while doing simple tasks, and also having difficulty doing any manual work, complains of a cough, fatigue, and weight loss, and has been treated for three respiratory infections a year for the past 3 years. On physical examination, CNP notice clubbing of his fingers, use accessory muscles for respiration, wheezing in the lungs, and hyperresonance on percussion of the lungs, and also pulmonary function studies show an FEV1 of 58%. These all symptoms and history represented here most strongly indicate the probability of chronic obstructive pulmonary disease (COPD). COPD is a respiratory disease categorized by chronic airway inflammation, a decrease in lung function over time, and gradual damage in quality of life (Booker, 2014).
* COPD: Chronic obstructive lung disease decreases the lungs ability to exchange carbon dioxide for oxygen. As the disease progress the patient has to work harder and harder to breathe often feeling as if they are suffocating. These disease are often link to a lifetime of smoking but be due to environmental factors.
The study began with 32 patients having stages II to IV COPD. They had to meet the criteria pertaining to the Global Initiative for Chronic Obstructive Pulmonary Disease; total lung capacity >120%, (FEV1/FVC) <70%, FEV1 <80%, RV/TLC >140% and >40% of predicted values in stable conditions. Patients were removed from the study if they had asthma, heart failure, orthopedic impairments of the shoulder girdle, recent surgery, past thoracic fractures, pneumothorax, and claustrophobia.
COPD is one of the greatest causes of disability and mortality in the twenty first century with future predictions painting an even graver story. Occupation, genome, and primarily smoking are the main causes of COPD. COPD is the third leading cause of death in America, claiming the lives of 134,676 Americans in 2010. Symptoms are typical of a constant smokers cough which progresses into the debilitating palliative stage of the disease; the development of co-morbidities exacerbates these symptoms. COPD has a complex pathophysiology involving hyperinflation, excessive mucus production and airway remodeling; diagnosis is through lung function tests. COPD is poorly managed with few effective treatments and a poor
Have you ever known a person who smokes and has a hard time doing every day activities, due to difficulty of breath, or constantly coughing. He or she may have Chronic Obstructive Pulmonary Disease, or COPD. COPD is a progressive and treatable lung disease that causes shortness of breath due to obstruction of air way (COPD, 2013). Progressive means that is gradually gets worse over time. It is a combination of chronic bronchitis and emphysema (Causes,2014). Chronic bronchitis is inflammation of the bronchioles, which causes mucus build up (Davis,2016). Emphysema is when the air sacs get enlarged (Smoking, 2016). Since the disease does not have a cure yet it is important to know pathology (path of disease), epidemiology (who is effected in a population), ethology (who is effected genetically), manifestation (symptoms), treatment, and outcome.
COPD is the continued tightening of the airways, causing a blockage to the airflow to the lungs, which causes shortness of breath. It chiefly comprises of emphysema and chronic bronchitis. Both are typically caused by smoking, or less frequently, by work-related exposure to dusts or
COPD is a disease that depletes a person of air. This disease is the fourth top cause of death in the United States. COPD describes several lung diseases including emphysema, chronic bronchitis, refractory asthma, and other forms of bronchiectasis. There is no average case, as every case is different from the next. This disease is long term but treatable.
COPD is characterized by persistent respiratory symptoms and airflow limitation as a result of significant exposure to noxious particles or gases
Rationale: L.J. exhibits symptoms of COPD that include shortness of breath and productive cough. He has a smoking history of 65-pack-year and smoking has been identified as the primary cause/trigger of the disease (Nagelmann et al., 2011).
Chronic obstructive pulmonary disease (COPD) is preventable disease that has a detrimental effects on both the airway and lung parenchyma (Nazir & Erbland, 2009). COPD categorises emphysema and chronic bronchitis, both of which are characterised by a reduced maximum expiratory flow and slow but forced emptying of the lungs (Jeffery 1998). The disease has the one of the highest number of fatalities in the developed world due to the ever increasing amount of tobacco smokers and is associated with significant morbidity and mortality (Marx, Hockberger & Walls, 2014). Signs and symptoms that indicate the presence of the disease include a productive cough, wheezing, dyspnoea and predisposing risk factors (Edelman et al., 1992).
Etiology: COPD is caused by long-term exposure to irritating gases or particulate matter, most often from cigarette smoke.
All over the world, chronic obstructive pulmonary disease (COPD) is a very significant and prevalent cause of morbidity and mortality, and it is increasing with time (Hurd, 2000; Pauwels, 2000; Petty, 2000). Due to the factor of COPD being an underdiagnosed and undertreated disease, the epidemiology (Pauwels, Rabe, 2004) is about 60 to 85 % with mild or moderate COPD remaining undiagnosed (Miravitlles et al., 2009; Hvidsten et al., 2010).
The World Health Organization (WHO) (2006A) defines COPD as a disease state characterized by airflow limitation that is not wholly reversible. The airflow limitation is usually both progressive and associated with abnormal inflammatory response of the lungs to noxious particles or gases. John's chronic bronchitis is defined, clinically, as the presence of a chronic productive cough for 3 months in each of 2 successive years, provided other causes of chronic cough have been ruled out. (Mannino, 2003). The British lung Foundation (BLF) (2005) announces that chronic bronchitis is the inflammation and eventual scarring of the lining of the bronchial tubes which is the explanation for John's dyspnea. The BLF (2005) believe that when the bronchi become inflamed less air is able to flow to and from the lungs and once the bronchial tubes have been irritated over a long period of time, excessive mucus is produced. This increased sputum results from an increase in the size and number of goblet cells (Jeffery, 2001) resulting in John's excessive mucus production. The lining of the bronchial tubes becomes thickened and an irritating cough develops, (Waugh & Grant 2004) which is an additional symptoms that john is experiencing.
Chronic Obstructive Pulmonary Disease, also known as COPD, is the third leading cause of death in the United States. COPD includes extensive lungs diseases such as emphysema, non-reversible asthma, specific forms of bronchiectasis, and chronic bronchitis. This disease restricts the flow of air in and out of the lungs. Ways in which these limitations may occur include the loss of elasticity in the air sacs and throughout the airways, the destruction of the walls between air sacs, the inflammation or thickening of airway walls, or the overproduction of mucus in airways which can lead to blockage. Throughout this paper I am going to explain the main causes, symptoms, diagnosis, and ways to reduce COPD.