Chronic obstructive pulmonary disease is a preventable and curable disease that develops due to prolonged inhalation of harmful particles and gases, irreversibly and progressing with the defeat of the alveoli, where there is a narrowing and exchange of gases in the bronchi.

COPD is a major health problem in our country and the world leading and increasing in frequency. In a BOLD (Burden of Lung Disease) study conducted in 37 countries, the incidence of COPD was found to be 11.8% in men and 8.5% in women. Around the World, 3 million people lose their lives due to COPD.It is projected to be the fourth most common cause of death in 2030, according to data from the World Health Organization. In fact, it is estimated that the number of patients with COPD is far above these figures, and 70-90% of patients do not receive a diagnosis. In our country, about 20% of adults over the age of 40. In other words, one in every 5 people has COPD. It is the most common cause of death and every year approximately 30 thousand people lose their lives due to COPD.

Symptoms and clinical table
Cough, phlegm, shortness of breath, wheezing are the most common symptoms. These symptoms may be very mild at the onset of the disease or none may be seen. Phlegm is usually coloured in the morning and dirty white. During infection periods, the color darkens and turns green. While shortness of breath initially occurs with intense exercise, it may increase in later periods to not be able to do daily activities.

İAdvanced patients describe it as asphyxiation. Due to poor lung function, the oxygenation of blood and the disposal of the accumulated carbon dioxide in the system is reduced. Due to low oxygen, bruising is seen on the fingertips and lips. The tendency to sleep due to the rise of CO2 in the blood, headaches can be observed. COPD is not just a lung disease.

It negatively affects all systems, especially the heart. Because the oxygen needed for tissue and cells is provided by our lungs. Heart failure, weight loss, pulmonary thrombo embolism (clot in the lung), depression can be seen.

Exacerbation of COPD, 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. Treatment of COPD exacerbations should be started early and respiratory failure should be prevented.

Risk Factors Risk Factors in people who have a history of exposure to COPD risk factors, such as shortness of breath, cough, and phlegm removal, should be considered and the diagnosis should be confirmed by spirometry. Spirometry is the gold standard in COPD diagnosis and evaluation. It is used to determine the stage of the disease and to evaluate the response to treatment.

Treatment Methods

COPD is a progressive disease that can be prevented and treated. The first step of treatment is quitting smoking. Then, to reduce the air confinement, to prevent flares and to reduce the shortness of breath with the bronchial opening drugs applied by the respiratory tract is started. The choice of medication is made according to the patient's additional diseases, age and the drugs he or she uses. The treatment of COPD should be made sure that additional diseases such as heart failure, hypertension, diabetes are under control. In addition to the 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 apparatus) , surgical and bronchoscopic treatment of emphysema are applied in patients with low oxygen levels in blood gas.

Resources Utilized

1. Global Iniatitivefor Chronic Obstructive Lung Disease (gold 2017), Global Strategy for the Diagnosis, Management and Prevention of COPD.

2. American Thoracic Society. Standarts fort he diagnosis and care of patients with chronic obstructive pulmonary disease (COPD). Am J Respir Crit Care Med 1995;152:s77-s120.

3.Turkish Thoracic Society's look at GOLD 2017 report