Pathology and Clinical Management of COPD

The predominant pathologic changes of COPD are found within the airways; however, changes are seen within the lung parenchyma and pneumonic vasculature. In an individual, the pattern of pathologic changes depends on the underlying illness (e.g., bronchitis, emphysema, alpha-1 antitrypsin deficiency), presumably individual susceptibility, and illness severity. High resolution computerized axial tomography can assess lung parenchyma, airways, and pneumonic vasculature. About 62 % of patients with moderate to severe COPD report variability in symptoms (e.g., dyspnea, cough, sputum, wheezing, or chest tightness) over the course of the day or week-to-week; morning is usually the worst time of day. An effective COPD management objective includes four components: assess and monitor the disease; reduce the risk factors; manage and stabilize COPD; manage the exacerbations. The most important factor for the COPD is cigarette smoking. The clinical management techniques involved to reduce the exacerbation of these factors that affect COPD must be developed in an efficient way.

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