ABBR: CLD. 1. Bronchopulmonary dysplasia. 2. An erroneous term for chronic obstructive lung disease.
chronic lung disease of the newborn
chronic obstructive lung disease
ABBR: COLD. Chronic obstructive pulmonary disease.
chronic obstructive pulmonary disease
ABBR: COPD. Any of a group of debilitating, progressive, and potentially fatal lung diseases that have in common increased resistance to air movement, prolongation of the expiratory phase of respiration, and loss of the normal elasticity of the lung. The chronic obstructive lung diseases include emphysema, chronic obstructive bronchitis, chronic bronchitis, and asthmatic bronchitis. Taken together, they make up the fourth most common cause of death in the U.S. The incidence of death from COPD is rising whereas the death rate from heart disease, cancer, and stroke (the three illnesses that currently cause more death in the U.S. than COPD) is falling). SYN: chronic airflow obstruction; chronic obstructive lung disease.
ETIOLOGY: Most patients with chronic airflow limitations are or were smokers, and their lung disease is a direct consequence of the toxic effects of tobacco smoke on the lung. A smaller number have been exposed to environmental tobacco smoke (second-hand smoke) or to dusts, chemicals, or smoke at work, or to environmental pollution. People who genetically lack the enzyme α-1 antitrypsin also develop COPD, typically at an earlier age than smokers (in their 40s instead of their 50s or 60s).
In the U.S. millions of people have COPD. About a half million Americans are admitted to hospitals each year with exacerbations of the disease.
SYMPTOMS: Diseases in this group are typically marked by difficulty breathing during exertion, as well as chronic cough and sputum.
TREATMENT: Acute exacerbations of COPD should be managed with inhaled bronchodilators, e.g., albuterol and ipratroprium, low flow oxygen (to raise the oxygen saturation to about 90%), antibiotics (if patients have more productive mucus than normal), and corticosteroids. For most patients who smoke, exacerbations occur several times a year. Patients with frequent exacerbations improve when treated with prophylactics such as azithromycin. Between exacerbations, disease management relies on smoking cessation and regular exercise (pulmonary rehabilitation), as well as supplemental oxygen, when it is needed. Additional preventive therapies include annual influenza vaccinations, and pneumococcal vaccination. Chronic management of COPD includes the use of anticholinergic agents, such as tiotropium, with long-acting beta agonists, like formoterol, and short-acting drugs, like albuterol. Corticosteroids have less benefit in chronic management (than in asthma) and can occasionally cause significant side effects. Aminophylline, a drug used extensively in the past for COPD, is now rarely used because of its interaction with other drugs and potential toxicity.
PATIENT CARE: The respiratory therapist teaches breathing and coughing exercises and postural ...