Outpatient management of chronic bronchitis in the elderly

Chronic bronchitis, one of the principal manifestations of obstructive lung disease, causes significant morbidity, especially among older patients. The "blue bloater" type of clinical presentation arises from hypoxemia and is characterized by breathlessness and functional impairments of communication and mobility. Acute infectious episodes often respond to antibiotic therapy, but the underlying problems of impaired airway immune responsiveness and hypersecretions cause chronic symptoms in many patients. Long-term management strategies are directed at optimizing immune defenses, improving airway patency through the use of anticholinergic and bronchodilating medications, correcting hypoxemia, providing supportive nutritional care and instituting measures to maximize the function of respiratory musculature.