review | COPD


It’s doesn’t get more bread and butter than this – the diagnosis and management of stable COPD. Every physician needs to know this through and through, and where better than a freshly updated guidelines. Here’s a brief summary of the updates:


  • Everyone with respiratory symptoms should have spirometry
  • Symptoms + FEV1 of 60-80% = bronchodilators (weak recommendation though)
  • Stable COPD + respiratory symptoms + FEV1 <60% = bronchodilators – use either long acting anti-cholinergics or LABAs (choose based on patient preference, cost, adverse effects)
    • if still symptomatic, consider combination therapies (weak)
  • Pulmonary rehab for those with an FEV1 < 50% (although can be considered for those with higher FEV1s if symptomatic or exercise limited)
  • Oxygen for those with a pO2 <55 or SpO2 <88%

Remember, these guidelines are just an update on the current (from 2007) and are specifically for stable COPD – which is what you mostly see in the clinics. 

Check out the article at the Annals of Internal Medicine, here

IMAGE NIH

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