Chronic Obstructive Pulmonary Disease

Chronic obstructive pulmonary disease (COPD) is a heterogeneous lung condition defined primarily by respiratory symptoms and airflow limitation. Cigarette smoking is the most common inhaled irritant leading to COPD, although other causes have been identified including air pollution, occupational, and biomass exposures. There is a well-described pathophysiology of chronic inflammation, which results in airway remodeling, airflow obstruction, hyperinflation, and reduced gas exchange. COPD has a progressive natural history, marked by episodes of clinical exacerbations, necessitating both acute and lifelong treatments. Medical management is based on severity of disease, based on symptoms and spirometry measurements. For select patients with severe disease and hyperinflation, lung volume reduction via surgical and bronchoscopic approaches may alleviate symptoms and improve pulmonary function. Lung transplantation may be an option for patients with end-stage disease.