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.