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Diagnosis and Management of Stable COPD: A Review
The ACP, ACCP, ATS and ERS give us this new clinical practice guideline & review on managing stable COPD. To sum up their recommendations:
1. If symptomatic, those with suspected COPD should be diagnosed with spirometry and offered treatment with bronchodilators if they indeed have COPD.
2. If FEV1 < 60% - then definitely treat with a single long-acting bronchodilator (LABA or anticholinergic).
3. And an inhaled steroid if you want to (this conflicts with GOLD's guideline that frequent exacerbations also be present).
4. Pulmonary rehabilitation if FEV1 < 50%; or earlier if you like.
5. Oxygen for the severely hypoxemic (paO2 < 55 mmHg or SaO2<=88%)
Oh, and smoking cessation counseling for everyone who smokes.
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