Chronic Obstructive Pulmonary Disease

Abstract

Chronic obstructive pulmonary disease (COPD) is a leading cause of disability and death worldwide. This edition reviews the epidemiology and etiologies of COPD, including the gender effects, racial differences, and more recently identified genetic factors associated with this condition. It details the many pathogenetic mechanisms thought to be associated with this disease state, such as increased airway inflammation and turnover of extracellular matrix. There is a detailed discussion about diagnosis, classification, and the therapeutic options available for both stable disease and acute exacerbations. The recent evidence supporting various treatments, such as vaccinations, inhaled bronchodilators, inhaled corticosteroids, oral corticosteroids, antibiotics, supplemental oxygen, pulmonary rehabilitation, and surgery, is reviewed in depth. There is further evaluation of experimental approaches, such as bronchoscopic lung reduction procedures and the use of extracorporeal carbon dioxide removal for hypercapnic respiratory failure. The many complications associated with COPD are described, acknowledging that evidence continues to suggest that COPD has a significant systemic component associated with increased rates of psychiatric illness, cardiovascular disease, osteoporosis, and skeletal muscle dysfunction along with lung cancer. Overall this text serves as an excellent evidence-based guide to better understand, diagnose, and manage COPD and its array of associated complications. This review contains 6 highly rendered figures, 6 tables, and 241 references Key words: chronic obstructive pulmonary disease (COPD), COPD complications, COPD diagnosis, COPD management, COPD pathophysiology, Global Initiative for Chronic Obstructive Lung Disease (GOLD)