COPD Flashcards
What is COPD (Chronic obstructive pulmonary disease)?
Progressive lung disease characterised by irreversible airflow limitation
Most common cause of COPD?
Smoking
What is COPD the umbrella term for?
Emphysema + chronic bronchitis
Symptoms of COPD?
SOB
Wheeze
Chronic cough
Signs of COPD?
Tachypnoea Use of accessory muscles Hyperinflation Pursed lip breathing Cyanosis Cor pulmonale (RHF)
Investigations for COPD?
Spirometry - obstructive, FEV1/FVC <70%
CXR - hyperinflation, flat hemidiaphragms, bullae
Management of COPD?
- SAMA/SABA
- THEN
if FEV >50% = LABA/LAMA
if FEV <50% = LABA + ICS/LAMA
- LAMA + LABA + ICS
What is acute exacerbation of COPD?
When an individual experiences a sustained increase in cough, sputum production, and/or SOB
Symptoms of exacerbation of COPD?
Increasing: SOB Wheeze Cough Sputum volume Fever Decreased exercise capacity
Most common cause of exacerbation of COPD?
Viral infection
Management of exacerbation of COPD?
BOSA
Bronchodilators – nebulised salbutamol and ipratroprium
O2 – only if sats <88% (aim for 88-92)
Steroids – prednisolone
Antibiotics – if purulent sputum or pneumonia on CXR e.g. doxycycline and co-amoxiclav
What is CPAP (Constant Positive Airway Pressure)?
Form of NIV that is useful in type I respiratory failure as it increases oxygenation
What is BIPAP (Bilevel Positive Airway Pressure)?
Form of NIV that is useful in type II respiratory failure as it increases oxygenation and facilitates carbon dioxide excretion
What is encompassed in NIV (non-invasive ventilation)?
CPAP + BIPAP
Two main measures used in NIV?
Inspiratory positive airways pressure (IPAP) = pressure applied during the inspiratory phase of the respiratory cycle
Expiratory positive airway pressure (EPAP) = pressure applied during the expiratory phase
CPAP: IPAP = EPAP
BIPAP: IPAP > EPAP
