Chronic Obstructive Pulmonary Disease (COPD) Inflammation and chronic obstruction of the bronchi

Chronic Obstructive Pulmonary Disease (COPD) is a "preventable" respiratory disease that is characterized by the existence of an irreversible, or partially reversible, bronchial obstruction.

Common symptoms are coughing and sputum, dyspnea and wheezing, difficulty breathing and tiredness.

It is a disease characterized by intermittent acute exacerbations, associated with a progressive worsening of symptoms and pulmonary function. An increased frequency of exacerbations increases the severity of the disease; as symptoms get worse, tiredness and lack of oxygen may lead to hospitalization and the need for treatment with supplemental oxygen.

COPD should be investigated in all patients with dyspnea, cough and/or sputum, as well as in asymptomatic patients with exposure to risk factors, such as smoking, which is the most frequent cause.

Tobacco aggravates bronchial inflammation, promoting obstruction and formation of sputum, aggravates respiratory difficulty, facilitates recurrent respiratory infections and leads to alveolar destruction and the formation of emphysema, with progressive worsening of respiratory capacity. This process is interrupted when you stop smoking.

The diagnosis of COPD is based on the assessment of symptoms and exposure to risk factors (tobacco, dust and inhaled gases) and on the presence of bronchial obstruction, as evidenced by the results a spirometry test.

The assessment includes the impact of symptoms on the patient's quality of life, the risk of future exacerbations and the severity of airflow obstruction.

In the treatment of patients with COPD, health education should be carried out, including the promotion of physical activity, the importance of adherence to the therapeutic plan, protection from exposure to environmental smoke and the prevention and control of smoking, through programs of smoking cessation.

Pharmacological therapy is performed with bronchodilators, according to the severity of the disease.

In patients with respiratory failure (partial or global), it may be necessary to perform long-term oxygen therapy or non-invasive ventilation.

As a preventive measure, all COPD patients should have an annual vaccine against the flu, as well as a pneumococcal vaccine.

Clinical follow-up of patients with COPD should include, at least, a medical consultation every 6 months and a spirometry every year.