| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
Guest Access | Sign In via User Name/Password
|
|
|
|||||||
Guest Access | Sign In via User Name/Password |
|||||||||
* From the Tufts University School of Medicine, Boston, MA.
Correspondence to: Bartolome R. Celli, MD, FCCP, St. Elizabeth’s Medical Center of Boston, Pulmonary and Critical Care Division, 736 Cambridge St, Boston, MA 02135
COPD is characterized by airflow limitation. The diagnosis is suggested by history and physical examination and is confirmed by spirometry (ie, a low FEV1 level that is unresponsive to bronchodilators). Once diagnosed, there is no widely accepted staging or severity scoring system. COPD presently is graded using a single measurement such as FEV1, which, unlike the case with asthma, has a limited role in disease management. A more comprehensive staging system is required incorporating, for example, age, arterial blood gases, dyspnea, body mass index, and distance walked, in addition to FEV1. These criteria should allow for more evidence-based recommendations for management of this condition. Asthma is an inflammatory disease also characterized by airflow limitation. But in contrast with COPD, the airflow limitation is highly reversible either spontaneously or with therapy. Repeated lung function measurements using portable peak flowmeters have resulted in improved outcomes. Therefore, frequent flow determination is recommended in the routine management of asthma. Treatment with anti-inflammatory agents and close monitoring of lung function should help decrease the morbidity and mortality associated with asthma.
Key Words: COPD • disease management • evidence-based medicine • spirometry • staging
This article has been cited by other articles:
|
|
 |
|
  M. L. Osborne, K. L. Pedula, M. O'Hollaren, K. M. Ettinger, T. Stibolt, A. S. Buist, and W. M. Vollmer Assessing Future Need for Acute Care in Adult Asthmatics: The Profile of Asthma Risk Study: A Prospective Health Maintenance Organization-Based Study Chest, October 1, 2007; 132(4): 1151 - 1161. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. W. Jones and A. G. N. Agusti Outcomes and markers in the assessment of chronic obstructive pulmonary disease. Eur. Respir. J., April 1, 2006; 27(4): 822 - 832. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N F Schlecht, K Schwartzman, and J Bourbeau Dyspnea as clinical indicator in patients with chronic obstructive pulmonary disease Chronic Respiratory Disease, October 1, 2005; 2(4): 183 - 191. [Abstract] [PDF]
|
|
|
|
|
|
P Enright Spirometry should be measured in the offices of general practitioners Chronic Respiratory Disease, April 1, 2005; 2(2): 109 - 111. [PDF]
|
|
|
|
 |
|
 C. Casanova, C. Cote, J. P. de Torres, A. Aguirre-Jaime, J. M. Marin, V. Pinto-Plata, and B. R. Celli Inspiratory-to-Total Lung Capacity Ratio Predicts Mortality in Patients with Chronic Obstructive Pulmonary Disease Am. J. Respir. Crit. Care Med., March 15, 2005; 171(6): 591 - 597. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Oga, K. Nishimura, M. Tsukino, S. Sato, and T. Hajiro Analysis of the Factors Related to Mortality in Chronic Obstructive Pulmonary Disease: Role of Exercise Capacity and Health Status Am. J. Respir. Crit. Care Med., February 15, 2003; 167(4): 544 - 549. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Nishimura, T. Izumi, M. Tsukino, and T. Oga Dyspnea Is a Better Predictor of 5-Year Survival Than Airway Obstruction in Patients With COPD* Chest, May 1, 2002; 121(5): 1434 - 1440. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. A. Pauwels National and International Guidelines for COPD : The Need for Evidence Chest, February 1, 2000; 117(2_suppl): 20S - 22S. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
