title: Management of advanced chronic obstructive pulmonary disease.
abstract: Successful Management of patients with advanced COPD includes not only a comprehensive therapeutic strategy tailored to the individual patient but also active patient participation. Figures 1 and 2 outline the medical and surgical treatment options for patients with advanced COPD. Patients who are actively smoking should be strongly advised to quit smoking. Bronchodilators and corticosteroids can improve symptoms and may prevent a further decline in lung function in selected COPD patients. The judicious use of antibiotics during an acute exacerbation may be required. O2 therapy improves survival and neuropsychiatric function in COPD patients with hypoxemia. Maintenance of proper nutrition is of utmost importance. A structured outpatient pulmonary rehabilitation is helpful in improving functional capacity and sense of breathlessness. In COPD patients who fail medical therapy, noninvasive positive pressure ventilation and surgical therapy may be considered.
authors.affiliation: Department of Medicine, Temple University School of Medicine Philadelphia, Pennsylvania 19140, USA.
authors.forename: F C
authors.initials: FC
authors.lastname: Cordova
authors.forename: G J
authors.initials: GJ
authors.lastname: Criner
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001993:Bronchodilator Agents / Q000627:therapeutic use; D006801:Humans; D008168:Lung / Q000601:surgery; D008173:Lung Diseases, Obstructive / Q000628:therapy*; D016040:Lung Transplantation; D010102:Oxygen Inhalation Therapy; D012121:Respiration, Artificial; D016540:Smoking Cessation; D013256:Steroids
chemical_list: D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D001993:Bronchodilator Agents; D013256:Steroids