Chronic Obstructive Airways Disease

Abstract

Chronic obstructive pulmonary disease (COPD) is a slowly progressive disease character-ised by increasing cough, wheeze and exertional breathlessness with associated airflow obstruction that is not fully reversible. The majority of patients have a 20-pack-year history of cigarette smoking. Typically, progressive decline in lung function with intermittent acute exacerbations leads to chronic respiratory symptoms, disability and respiratory failure. The term COPD encompasses varying combinations of pulmonary emphysema, chronic bronchitis and chronic severe asthma, and it may be difficult to define the relative importance of each in an individual patient. Over the last 10 years there have been numerous COPD guidelines pub-lished, many of which differ in detail. This chapter includes guidelines from the National Institute for Clinical Excellence (NICE, UK)₁, the ATS/ERS standards for the diagnosis and treatment of pa-tients with COPD position paper₂, the National Institute for Health (USA) Global Initiative for Chronic Obstructive Lung Disease₃, the British Thoracic Society Guidelines₄, the American Tho-racic Society guidelines₅ and a BMJ review₆.