COPD affects over 600 million people worldwide. In the Philippines, it is ranked as the 7th leading cause of mortality. Ironically, as much as 50% people affected are not aware that they have the disease. The disease is often misdiagnosed as asthma. We should be aware of the manifestations of COPD so that proper interventions could be done in the patient having such disease. Oxygen, a clear odourless gas that constitutes approximately 21% of the air we breathe, is necessary for proper functioning of all living cells. The absence of oxygen can lead to cellular, tissue, and organism death. Although the delivery of oxygen to body tissues is affected by other body systems, the respiratory system is most directly involved in this process. Impaired function of the system can significantly affect our ability to breathe, transport gases, and participate in everyday activities. These impairments are exactly what a COPD patient is experiencing due to the disease process. Chronic Obstructive Pulmonary Disease (COPD) is defined as a preventable and treatable disease with some significant extra pulmonary effects that may contribute to the severity in individual patients. Its pulmonary components are characterized by air flow limitation that is not fully reversible. The air flow limitation is usually progressive and associated with an abnormal inflammatory response of the lungs to noxious particles or gases. COPD may include diseases that cause air flow obstruction such as Emphysema and Chronic Bronchitis or any combination of these orders. In emphysema, impaired oxygen and carbon dioxide exchange results from destruction of the walls of overdistended alveoli. This causes a state of carbon dioxide retention, hypoxia, and respiratory acidosis. This may be caused by cigarette smoking, infection, inhaled irritants, allergic factors, aging, heredity-Alpha1-antitrypsin deficiency. Chronic Bronchitis, a disease of the airways, is defined as the presence of persistent cough and excessive sputum production. This causes hypertrophy/hyperplasia o f the mucus-secreting glands in the bronchi, decreased ciliary activities, chronic inflammation, and narrowing of small airways. This is caused by the same factors that cause emphysema except that it is not caused by a genetic defect. COPD is classified into four stages depending upon severity (measured by pulmonary function tests) and symptoms.
The basic "standard" for evaluating the severity of COPD has primarily been spirometry, also known as the Pulminary Function Test (PFT). However, functional dyspnea, body mass index (BMI), and FEV1 from Spirometry, when evaluated collectively, offer better insight into outcomes such as survival. Most times, the spirometry results are the only referenced statistics. Spirometric Classification
The normal lung function, when measured with Spirometry, diminishes approximately 5% every 10 years after age 35 years old. Therefore, it is rare for a person over 35 to have a “100%” In addition, the normal values for the FVC and FEV (2 of the measurements in a pulmonary function test) vary depending on age, height, sex and race. The numbers are higher for:
35 years old vs 65 years old
Taller than shorter builds
Men than women
Caucasian than most other races.
The number used (FEV1) is a percent of the average expected of someone of your height, age, sex and race. It is expressed as a percent of predicted. Any number over 80% is considered normal STAGE
Pulmonary Function Tests (PFT) with an FEV1 result of: STAGE I
Often minimal shortness of breath with or without cough and/or sputum. Usually goes unrecognized that lung function is abnormal
> 80% of predicted STAGE II
Often moderate or severe shortness of breath on exertion, with or without cough, sputum or dyspnea. Often the first stage at which medical attention is sought due to chronic respiratory symptoms or an exacerbation
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