Chronic Obstructive Pulmonary Disease

Pathophysiology

Chronic Obstructive Pulmonary Disease (COPD) is a disease that occurs in the lungs limiting the airflow and ability to breathe. The limited airflow occurs due to the lung tissue breaking down and blocking the airways. As the lung tissue continues to break down emphysema can be diagnosed, which is characterized by the continuing narrowing of the airways. The individual is affected mainly when they are breathing out as the pressure in the chest narrows the cavity. This leads to the individual attempting to breathe faster or harder in an effort to expel the air from the lungs.    

Presentation

The narrowing of the airways makes it difficult for an individual to breathe out leading to shortness of breath. Individuals with COPD also have chronic coughs and a number of co-occurring lung disorders such as emphysema. These symptoms along with a production of sputum can be signs that an individual has COPD. Further testing can be done to diagnose the condition. These tests can include a spirometer that would measure the force of the expelled air; chest x-rays and blood work to accurately diagnose the condition. If the spirometer indicates that the individual is at 30% or lower for expelling air it would indicate that they are in the severe category for the condition. 

Population

COPD is typically diagnosed in individuals between the ages of 35 and 40. The most common cause of COPD has been found to be cigarette smoking. “It is a global health issue, with cigarette smoking being an important risk factor universally; other factors, such as exposure to indoor and outdoor air pollution, occupational hazards, and infections, are also important” (Mannino & Buist, 2007, p. 765). The individual would need to have smoked for decades as this is the time it would require for the breakdown of the lung tissue to occur. Other factors such as air pollution have also been considered to be a contributor to COPD prevalence. Genetic factors can also contribute to the risks of the disease as individuals who have family members with COPD are at a higher risk of developing the condition. While these genetic factors may exist the environmental factors lead to the condition developing. 

Patient Management

COPD cannot be cured once it has been diagnosed. There are several treatment options available for individuals with COPD such as breathing treatments in the form of bronchodilators that reduce shortness of breath, breathing exercises, or medications such as steroids. In extreme cases, surgery can be performed on the lungs to remove parts that are no longer expelling air. These treatments can improve the quality of life for an individual with COPD. However prevention is vital to the treatment of COPD as smoking cessation programs are needed to prevent individuals from damaging their lungs.   

Prognosis

The prognosis of COPD is dismal as the condition does not improve with time or treatments. COPD leads to death in most cases. This can vary from case to case as an individual who is treating the condition and following through with recommendations may have a better prognosis than others. The prevalence of the condition is also high. “The prevalence of physiologically defined chronic obstructive pulmonary disease in adults aged ≥40 yrs. is ∼9–10%” (Halbert et al., 2006, p. 523). Individuals with COPD most often need to be placed on disability as they are no longer able to work with the condition. COPD has also begun to globally affect millions of individuals as smoking continues to be on the rise in other countries, especially developing nations. Programs to prevent the condition need to continue to be funded in order to improve these rates. 

References

Halbert, R. J., Natoli, J. L., Gano, A., Badamgarav, E., Buist, A. S., & Mannino, D. M. (2006). Global burden of COPD: Systematic review and meta-analysis. European Respiratory Journal, 28(3), 523-532.

Mannino, D. M., & Buist, A. S. (2007). Global burden of COPD: Risk factors, prevalence, and future trends. The Lancet, 370(9589), 765-773.