- Sputum pot
- Respiratory rate
- Use of accessory muscles
- Pursed lips
- Nicotine stain
- Bounding pulse
Guidelines from the Global Initiative for Chronic Obstructive Lung Disease (GOLD) state that the airflow limitation in COPD is characterized by :
FEV1 value that is < 80 % of the predicted normal value.
FEV1:FVC ratio of < 0.70
how would you invesgate this patient?
what are the Treatment options?
treatment can be divided into acute and chronic presentation.
Treatment of exacerbation:
- Neublized bronchodilator
- role of non-ivasive ventlation.
Indications for LTOT:
1-ABG’s measured in clinically stable patient on optimal medical therapy, on at least two occasions 3 weeks apart.
2- Pao2 < 7.3 (irrespective of PaCo2)
3- Pao2 7.3-8 + pul hypertension
4-patient stopped smoking.
Oxygen should be used at least 15 hours per day at 2-4 litres/min
To achieve Pao2 >8 without unacceptable rise in PaCo2
Indication for lung transplant:
- Untreatable end-stage pulmonary disease of any etiology
- Absence of other significant medical diseases
- Substantial limitation of daily activities
- Limited life expectancy
- Ambulatory patient with rehabilitation potential
- Acceptable nutritional status
- Satisfactory psychosocial profile and emotional support system