COPD

COPD is a leading and increasingly important health problem in our country and all over the world. In the BOLD (Burden of Lung Disease) study conducted in 37 countries, the incidence rate of COPD was found to be 11.8% in men and 8.5% in women. All over the world, 3 million people die due to COPD. According to the data of the World Health Organization, it is predicted to be the fourth most common cause of death in 2030. In fact, it is estimated that the number of patients with COPD is much higher than these figures and 70-90% of the patients are not diagnosed. In our country, it is approximately 20% in adults over the age of 40. In other words, COPD is seen in one out of every 5 people. COPD is the 3rd most common cause of death in Turkey and about 30 thousand people lost their lives due to COPD every year.

Symptoms and Clinical Status

Cough, sputum, shortness of breath, wheezing are the most common symptoms. At the beginning of the disease, these symptoms may be very mild or none. Sputum is usually in the morning and off-white in color. During periods of infection, the color may darken and turn yellow green. Shortness of breath initially appears with intense exercise, but in the following periods, it may increase so that they cannot do their daily activities. Advanced stage patients describe this as suffocation. Due to insufficiency in lung functions, oxygenation of the blood and removal of carbon dioxide accumulated in the system are reduced. Due to the lack of oxygen, bruising is seen on the fingertips and lips. Drowsiness and headaches may be observed due to increased CO2 in the blood. COPD is not just a lung disease. It negatively affects the whole system, especially the heart. Because the oxygen required for tissues and cells is provided by our lungs. Heart failure, weight loss, pulmonary thromboembolism (clot in the lung), depression can be seen.
COPD exacerbation, shortness of breath, worsening of cough and sputum complaints, and the need for additional medication. Infectious diseases, smoking, air pollution are risk factors for exacerbation. Exacerbations are the most important cause of COPD deaths. In COPD exacerbations, treatment should be initiated early and the development of respiratory failure should be prevented.

Risk factors

COPD should be considered in patients with shortness of breath, cough and sputum production, and a history of exposure to COPD risk factors, and diagnosis should be confirmed by spirometry. Spirometry is the gold standard in the diagnosis and evaluation of COPD. It is used to determine the stage of the disease and to evaluate the response to treatment.

Treatment Methods

Although COPD is a progressive disease, it is a preventable and treatable disease. The first step of treatment is quitting smoking. Afterwards, bronchodilator drugs administered through the respiratory tract are started to reduce air trapping, prevent exacerbations and reduce shortness of breath. The choice of medication is made in line with the patient’s additional diseases, age and medications used. In the treatment of COPD, it should be ensured that additional diseases such as heart failure, hypertension and diabetes are under control. In the treatment, in addition to appropriate and effective medical treatment, annual flu vaccine, pneumonia vaccine, respiratory physiotherapy should be applied to prevent exacerbations.
Long-term Oxygen Therapy, pulmonary rehabilitation, Non-Invasive Mechanical Ventilation (breathing devices), surgical and bronchoscopic treatments of emphysema are applied in patients with low oxygen in the blood gas.
Resources
1. Global Initiative for Chronic Obstructive Lung Disease (gold 2017), Global Strategy for the Diagnosis, Management and Prevention of COPD. Available from : http://goldcopd.org.
2ND American Thoracic Society. Standards for the diagnosis and care of patients with chronic obstructive pulmonary disease (COPD). Am J Respir Crit Care Med 1995;152:s77-s120.
3. Türk Toraks Derneği’nin GOLD 2017 raporuna bakışı