Chronic Obstructive Pulmonary Disease (COPD) Definition
According to Canadian Health&Care Mall chronic obstructive pulmonary disease (COPD) is an independent progressive disease that is characterized by not only inflammatory component, but also structural changes in pulmonary vessels and tissue. In addition, it should be mentioned about serious bronchial obstruction violations. This obstruction is localized in distal bronchial area. This disease is separated from a number of typical chronic processes of not unimportant respiratory system. It is proved that chronic obstructive pulmonary disease most often affects men over 40 years. It takes major position among disability causes. Moreover, there is a high risk of mortality even among working-age population. COPD life expectancy depends on disease severity and patients lifestyle. At increased bronchial mucus production and its viscosity, most favorable conditions for rapid bacteria growth are created. In this case bronchial tubes patency is violated, lung tissue and alveoli change. Disease progression leads to bronchial mucosa swelling, mucus secretion and smooth muscles spasms. Often COPD is accompanied by bacterial complications and pulmonary infections relapses. It happens that chronic obstructive pulmonary disease is greatly exacerbated by severe gas exchange disorders that manifest in significant oxygen decrease in blood and high blood pressure. Such COPD exacerbation provokes circulatory insufficiency, which causes death in about 30% of patients with this diagnosis.
COPD Causes and Risk Factors
There were carried out many researches and surveys to distinguish what causes COPD. The main reason is considered to be smoking. Among other factors chronic obstructive pulmonary disease development and exacerbation causes include respiratory infections in childhood, industrial hazards, associated bronchopulmonary disease, as well as poor ecology. In a small number of patients, the disease is based on genetic predisposition that is expressed in alpha-1-antitrypsin protein deficiency. It is formed in liver tissues, protecting lungs from serious damage. According to Canadian Health&Care Mall statistics, as a rule, chronic obstructive pulmonary disease is considered an occupational disease of many railway workers, miners, constructors, and workers who contact with cement. Often, the disease occurs at metallurgical and pulp and paper industry specialist. Genetic predisposition and environmental factors cause bronchial inner membrane inflammation of chronic nature, which significantly reduces local immunity.
COPD Symptoms and Stages
There are several classifications of chronic obstructive pulmonary disease. At zero stage disease manifests itself in strong mucus secretion and persistent cough on the background of continued lung function. For the first stage chronic cough, sputum production and slight obstructive disorders are characteristic. At moderate conditions different clinical symptoms can be observed that worsen at a certain load. At the same time pronounced obstructive disorders progress. At the third disease stage at exhalation air flow restriction grows. More frequent exacerbations and increased dyspnea may be noted. At extreme conditions (end-stage COPD) severe bronchial obstruction appear, which may threaten human’s life. Pulmonary heart develops and dangerous respiratory insufficiency is diagnosed. It is worth mentioning that at very early stages, chronic obstructive pulmonary disease can occur unnoticable. Often typical clinical symptoms of the disease manifest at moderate conditions. COPD has strong cough with dyspnea and sputum. Sometimes COPD early symptoms are occasional cough, accompanied by release of large amounts of mucous expectoration. During this period dyspnea during intense stress also can be observed. Cough becomes permanent only as the disease progresses. When specific infection joins to COPD dyspnea is observed at rest and sputum becomes of purulent character. Chronic obstructive pulmonary disease course develops by either emphysematous, or bronchial type. Many patients with bronchial type of the disease complain of cough, excessive sputum production. Intoxication, skin cyanosis and dangerous purulent bronchial inflammation may also be noted, and there is a significant obstruction expression at weak pulmonary emphysema. Patients with COPD of emphysematous type differ with expiratory dyspnea, which is characterized by labored exhale. Pulmonary emphysema predominates greatly over typical bronchial obstruction. Patients’ skin becomes gray-pink, and thorax is barrel-shaped. It should be mentioned that under favorable benign course all patients survive to old age. In most cases, progressive disease development is complicated by acute respiratory insufficiency and pneumonia. Sometimes spontaneous pneumothorax, secondary polycythemia, pneumosclerosis, and congestive cardiac insufficiency are diagnosed. At very severe stages, some patients may observe pulmonary heart or pulmonary hypertension. Absolutely in all cases, the disease leads to decrease in quality of life and activity.
Timely chronic obstructive pulmonary disease diagnostics can increase life expectancy for patients and improve quality of their lives. When gathering anamnesis, modern experts always pay attention to factors of production and unhealthy habits. The main method of functional diagnostics is considered to be spirometry. It reveals initial signs of the disease. Also it is important to measure volume and speed parameters. They include vital lung capacity, forced lung capacity, as well as forced expiratory volume per second. To make a diagnosis, ratio and sum of identified indicators is quite enough. To assess severity and nature of bronchial tubes inflammation cytological method of patients’ sputum analysis is used. At exacerbation state sputum is always viscous and at the same time purulent. Clinical blood tests help to identify polycythemia, which is possible because of dangerous hypoxemia development only at bronchial type of the disease. Amounts of erythrocytes, hemoglobin, hematocrit and blood viscosity are determined. The main event of respiratory insufficiency is considered blood gases. To exclude other similar diseases pneumonography is indicated. COPD is characterized by bronchial walls deformation, as well as changes in lung tissue of emphysematous nature. ECG can detect if and how copd causes pulmonary hypertension development, and diagnostic bronchoscopy is necessary to assess bronchial mucosa state and sampling analysis of its secret.
COPD Treatment Guidelines
The main goal of COPD treatment is considered to be slowdown of all progressive processes, removal of obstructions and elimination of respiratory insufficiency. It is necessary to increase patients’ longevity and quality of lives. Removing disease cause, such as smoking or factors of production, is a necessary treatment in combination therapy. Treatment starts with training patient to use spacers, nebulizers and inhalers, as well as independent assessment of his condition. At the same time bronchodilators and mucolytics are appointed to thin sputum and expand bronchi. Then inhaled steroids are usually prescribed, and during acute exacerbations antibiotics are administered. If necessary, pulmonary rehabilitation and body oxygenation is appointed. Reducing COPD development rate is only possible in case of methodical complex treatment that is chosen appropriately for each individual patient. Studies by Canadian Health&Care Mall show that, as a rule, prognosis is favourable regarding complete patients’ recovery. In case of constant disease progression doctors talk about disability. It should be noted that main prognostic criteria include excluding provoking factors, and most importantly, patient’s compliance with therapeutic measures and all recommendations.
COPD Prevention Guidelines
Preventing further development of chronic obstructive pulmonary disease is the most important COPD prevention method. Abstinence from smoking is a major requirement for disease progression. Passive smoking is also considered unacceptable. Complex approach against disease ensures prolonging life duration. You should also pay special attention to other respiratory infections, that can provoke COPD relapse. For prevention of relapse and exacerbation long-term reception of special mucolytics, which have antioxidant activity, is considered a promising measure. Since COPD is an incurable disease, it is necessary to keep to proper way of life, control symptoms, due to which you can significantly slow disease’s development. Proper preventive measures will allow patient to return to high-quality living environment.