COPD – chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD) is characterized by a persistent and usually increasing narrowing of the airways. This narrowing results from inflammation in the area of the small airways and from destruction of lung tissue (emphysema). In addition to genetic factors and pre-existing lung conditions, smoking and other inhalant exposures play a crucial role in the development of the disease.

COPD is a common disease and affects 5-10% of the population, with men and women affected in approximately equal proportions.

Typical symptoms of COPD are chronic cough (with sputum), shortness of breath on exertion, chest tightness and whistling breath sounds.

Further clarification is carried out in particular by lung function testing. Here, the constriction of the bronchial tubes can be determined. In addition, the large lung function examination in the cabin (bodypletysmography) with measurement of the gas exchange, a possible overinflation of the lungs and the extent of the destruction of lung tissue (pulmonary emphysema) can be determined.

Exercise tests, laboratory tests, analysis of blood gases and X-ray examinations complete the diagnostics.

The aim of the therapy is to improve the quality of life and performance. In addition, further deterioration should be counteracted.

Fast-acting inhaled medications (SABA, e.g. salbutamol) are available for rapid relief of respiratory distress. These drugs have only a short duration of action.

In the case of chronic disease, basic therapy is usually carried out with long-acting inhalative medications (LABA, LAMA). The duration of action here is 12-24 hours, depending on the preparation.

In certain situations, improvement can be achieved with inhaled cortisone or Roflumilast.

In addition to treatment with inhaled medications, there are a variety of other treatment options. These include smoking cessation, vaccinations, education, physical training, pulmonary exercise, oxygen therapy, ventilation therapy, and in individual cases, endoscopic elimination of overinflated lung areas and lung transplantation.

If the absorption of oxygen is severely restricted, oxygen therapy may be necessary. First, the oxygen content in the blood is determined. If the partial pressure of oxygen (PaO2) is < 55 mmHg (or 55-60 mmHg in certain situations), an improvement can be achieved by administering oxygen. For this purpose, various stationary devices are available for use at home, as well as mobile devices for use on the road.

If, in addition to the uptake of oxygen, the exhalation of carbon dioxide is also restricted, ventilation can be improved by means of a mask.

Especially in mild disease, the subjective impairment is characterized by airway narrowing and can be well treated with inhaled medications. However, the majority of patients do not die from COPD, but from cardiovascular diseases and lung cancer. Osteoporosis, muscle weakness, diabetes and mental illness are also associated with COPD. Therefore, thorough internal medicine treatment of the whole person is always required.