Chronic Obstructive Pulmonary Disease, Definition, Signs And Symptoms

CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD)

Definitions:-A disease state categorized by airflow restraint that is not fully reversible. The airflow restriction is usually both progressive and related with an abnormal inflammatory reaction of the lungs to noxious subdivisions or gases.

Incidence:-

»The Worldwide Problem of Disease Revision reports a prevalence of 251 million cases of Chronic obstructive pulmonary disease (COPD) worldwide in 2016.

»Worldwide, it is assessed that 3.17 million expiries were caused by the disease in 2015 year.

»Additional than 90% of COPD losses occur in low­ and middle-income countries.

»The main cause of COPD is exposure to tobacco smoking.

»Additional risk factors include contact to indoor and outdoor air pollution and work-related dusts and fumes.

»Contact to indoor air pollution can affect the unborn child and represent a risk factor for developing COPD later in life.

»COPD is not curable, but treatment can relieve symptoms, recover quality of life and decrease the risk of death.

»It is most commonly diagnosed in older men; however, the incidence is increasing in women owing to an increasing population of women smokers.

»Women may be more likely to have more rapidly progressive Chronic obstructive pulmonary disease (COPD) than men.

Signs & Symptoms:-

∗Chronic cough

∗Sputum production

∗Dyspnea

∗Chronic productive cough

∗Tachypnea,

∗Pursed-lip breathing

∗Prolonged expiration

∗Hyper resonance on percussion

∗Diaphragmatic excursion

∗Diminished breath sounds




Classification of Chronic obstructive pulmonary disease (COPD) Severity:-

Stage 0: At Risk

May have one or more symptoms of chronic cough, sputum

production, or dyspnea

Exposure to risk factors

Normal spirometry

Stage I: Mild

FEV1/FVC < 70%

FEV1 ≥ 80%

With or without symptoms

Stage II: Moderate

FEV1/FVC < 70%

50% < FEV1 < 80%

With or without symptoms

Stage III: Severe

FEV1/FVC < 70%

30% < FEV1 < 50%

With or without symptoms

Stage IV: Very Severe

FEV1/FVC < 70%

FEV1 < 30% or <50% with presence of chronic respiratory failure or

right heart failure

Risk factors for the development of Chronic obstructive pulmonary disease COPD:-

Smoking:-

Risk increases with increasing consumption but there is also large inter individual variation in susceptibility

Age:-

Increasing age results in ventilator impairment; most frequently related to cumulative smoking

Gender:-

Male gender be situated before thought to be a risk factor but this may be due to a higher incidence of tobacco smoking in men. Women have more airway reactivity and experience faster declines in FEV1, so may be at more risk than men

Occupation:-

The development of COPD has been implicated with occupations such as gas and gold, coal mining, farming, grain handling and the cement and cotton industries

Genetic factors:-

Alpha1-Antitrypsin deficiency is the strongest single genetic risk factor, accounting for 1–2% of COPD. Other genetic syndromes involving tissue necrosis issue and epoxide hydrolase may also be risk factors

Air pollution:-

Death rates are higher in urban zones than in rural spaces. Indoor air pollution from fiery biomass oil is also occupied as a risk reason, particularly in underdeveloped areas of the world

Socio-economic status:-

More common in personnel of low socio-economic status

Airway hyper-responsiveness:-

and allergy Smokers show increased levels of IgE, eosinophils and airway hyper-responsiveness but how these influence the development of COPD is unknown.



Pathophysiology:-

Chronic bronchitis

»Respiratory tissue inflammation:- results in vasodilation, congestion, mucosal edema, and goblet cell hypertrophy.These happenings trigger goblet cells to create extreme quantities of mucus.

»Deviations in tissue:- include augmented smooth muscle, cartilage atrophy, infiltration of neutrophils and other cells, and impairment of cilia.

»Airways turn into blocked by thick, tenacious mucous secretions, which cause a productive cough.

»Normally, sterile airways can become colonized with Streptococcus pneumoniae, Haemophilus influenza, Moraxella catarrhalis, Staphylococcus aureus, and Pseudomonas aeruginosa Recurring lung infections (viral and bacterial) decrease ciliary and phagocytic action, rise mucus accumulation, weaken the body’s resistances, and additional finish small bronchioles.

»As the airways degenerate, generally gas altercation is impaired, producing exertional dyspnea.

»Hypoxemia outcomes after a V/Q inequity and is returned in an growing arterial carbon dioxide tension.

»Sustained hypercapnia desensitizes the brain’s respiratory control center and central chemoreceptors. As a result, compensatory action to correct hypoxemia and hypercapnia does not happen. Instead, hypoxemia serves as the stimulus for breathing. Usage of sedatives or benzodiazepines, especially in combination, should be done carefully in these patients to avoid respiratory failure.

Read More-  Chronic Obstructive Pulmonary ,Diagnosis, Treatment And Life Style Changes.

Conclusion:-

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Post Author: surya20

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