[Diagnosis and management of chronic obstructive pulmonary disease]

Chronic obstructive pulmonary disease (COPD) is an increasing health problem and one of the leading causes of morbidity and mortality worldwide. Cigarette smoking remains the main risk factor. COPD is preventable, readily diagnosable and treatable disease. The appropriate and early use of spirometry for diagnosis is of importance. A comprehensive treatment plan for managing patients with COPD involves the use of pharmacological as well as nonpharmacologic interventions. Smoking cessation can substantially reduce the risk for the development or rate of progression of COPD. Bronchodilator therapy is a basis in symptomatic treatment. Inhaled steroids might reduce frequency and severity of exacerbation and can be effectively combined with long acting beta2 agonists. Pulmonary rehabilitation benefits most patients. Patients with hypoxemia suffering from more severe disease may require a long-term oxygen therapy. Surgical intervention may help a limited number of patients.