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COPDX: an update of guidelines for the management of chronic obstructive pulmonary disease with a review of recent evidence
Author(s) -
Abramson Michael J,
Crockett Alan J,
Frith Peter A,
McDonald Christine F
Publication year - 2006
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.2006.tb00268.x
Subject(s) - medicine , copd , anticholinergic , pulmonary rehabilitation , aminophylline , intensive care medicine , dynamic hyperinflation , pulmonary function testing , pulmonary disease , positive pressure ventilation , physical therapy , anesthesia , lung , respiratory failure , lung volumes
Long‐acting β 2 agonists are an effective and convenient treatment for chronic obstructive pulmonary disease (COPD), but do not significantly improve lung function. The long‐acting anticholinergic tiotropium, which can be taken once daily, decreases exertional dyspnoea and increases endurance by reducing hyperinflation. The role in COPD of the combination of a long‐acting β 2 agonist and a glucocorticoid in a single inhaler remains unclear. The minimum duration of an effective pulmonary rehabilitation program that includes exercise training is 6 weeks. Long‐term treatment with inhaled glucocorticoids may reduce the rate of decline in lung function, but the effect is small. Aminophylline should no longer be routinely used in acute exacerbations of COPD. Non‐invasive positive pressure ventilation (NPPV) reduces mortality and hospital stay in patients with acute hypercapnic ventilatory failure; it is also an effective weaning strategy for patients who require intubation. Further studies are required to clarify the role of NPPV in the long‐term management of stable COPD.