Chronic Obstructive Pulmonary Disease is a preventable and treatable disease that develops due to the inhalation of harmful particles and gases for a long time, irreversibly and progressively with the destruction of alveoli where shrinkage and gas exchange is achieved in the bronchi.

COPD is an important and increasingly important health problem in our country and all over the world. In the BOLD (Burden of Lung Disease) study conducted in 37 countries, the incidence of COPD was found to be 11.8% in men and 8.5% in women. 3 million people around the world die due to COPD. According to the data of the World Health Organization, it is predicted that it will be the fourth most common cause of death in 2030. In fact, the number of patients with COPD is estimated to be much higher than these numbers, and 70-90% of patients are not diagnosed. In our country, it is approximately 20% in adults over 40 years old. In other words, COPD is seen in one out of every 5 people. It is the third most common cause of death in Turkey and about 30 thousand people are losing their lives due to COPD every year.

 

Symptoms and Clinical Table

Cough, sputum, shortness of breath, wheezing are the most common symptoms. At the beginning of the disease, these symptoms may be very mild or none of them may be seen. Sputum is usually occurred in the mornings and the color is off-white. During the infection period, its color may darken and change to yellow green. While shortness of breath appears with intense exercise at the beginning, it may increase too much to do daily activities in the following periods. Advanced stage patients describe it as suffocation. Due to insufficient lung function, oxygenation of the blood and the removal of carbon dioxide accumulated in the system are reduced. Due to the low oxygen level, bruising appears on the toes and lips. The tendency to sleep due to the increase in CO2 in the blood, headaches can be observed. COPD is not just lung disease. It affects all systems, especially the heart, negatively. Because the oxygen required for tissues and cells is provided by our lungs. Heart failure, weight loss, pulmonary thromboembolism (clotting into the lung), depression can be seen.

COPD exacerbation, shortness of breath, cough and worsening of sputum complaints and need for additional medication. Infectious diseases, smoking, air pollution are risk factors for exacerbation. Exacerbations are the most important cause of COPD deaths. In COPD exacerbations, treatment should be started early and the development of respiratory failure should be prevented.

 

Risk Factors

COPD should be considered in patients with shortness of breath, cough and expectoration, and a history of exposure to COPD risk factors, and the diagnosis should be confirmed by spirometry. Spirometry is the gold standard in the diagnosis and evaluation of COPD. It is used to determine the stage of the disease and to evaluate the response to treatment.

 

Treatment Methods

COPD is a progressive disease that can be prevented and treated. The first step of treatment is smoking cessation. Then, with the aim of reducing air confinement, preventing exacerbations and reducing shortness of breath, bronchial opening medications are started. The choice of medication is made in accordance with the patient’s additional diseases, age and the drugs used. In the treatment of COPD, it should be ensured that additional diseases such as heart failure, hypertension and diabetes are under control. In addition to appropriate and effective medical treatment, annual flu vaccine, pneumonia vaccine and respiratory physiotherapy should be used in the treatment.

Long-term Oxygen Therapy, pulmonary rehabilitation, Non-Invasive Mechanical Ventilation (respiratory devices), surgical and bronchoscopic treatments are applied in patients with low oxygen levels in blood gas.

 

References

  1. Global Inatiativefor Chronic Obstructive Lung Disease (gold 2017), Global Strategy for the Diagnosis, Management and Prevention of COPD. Available from: http://goldcopd.org.
  2. American Thoracic Society. Standarts fort he diagnosis and care of patients with chronic obstructive pulmonary disease (COPD). Am J Respir Crit Care Med 1995; 152: s77-s120.
  3. The Turkish Thoracic Society’s view of the GOLD 2017 report