[Causal proceeding in chronic obstructive pulmonary disease]

At present, chronic obstructive pulmonary disease (COPD) is considered as serious clinical, social and economic problem. Widespread habit of smoking together with air-pollutions is the basic etiologic factors, whereas inflammatory process, which involves bronchial tree and pulmonary tissues, is the core of COPD pathogenesis. Quality of life has much been improved by the introduction of pharmacological treatment including: long-acting beta2-mimetics, cholinolytics, mucolytics and in severe cases inhaled glucocorticosteroids. Prophylactic immunization against influenza and pneumococci also has been proved to be helpful. Continuous patient education together with efforts promoting smoking cessation constitute the mainstay of non-pharmacological management. Chronic oxygen therapy, respiratory rehabilitation and non-invasive ventilation proved to be a practical alternative in patients with chronic respiratory failure. Lung-volume-reduction surgery may sometimes be considered as an alternative to lung transplantation in very severe cases of COPD.