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CHRONIC OBSTRUCTIVE PULMONARY DISEASE
Treatment Guideline Chart

Chronic obstructive pulmonary disease (COPD) is an inflammatory respiratory disease characterized by reversible airflow limitation.

The patient usually has chronic cough, sputum production or dyspnea with or without history of risk factors for the disease.

The chronic airflow limitation is caused by a combination of small airways disease and parenchymal destruction.

It is a preventable and treatable disease.

Surgical Intervention

  • Surgery may be considered in patients who have large bullae, or have severe COPD with marked functional impairment in spite of maximal medical treatment
  • Surgical procedures for COPD include the following:
    • Bronchoscopic lung volume reduction (BLVR): For patients with heterogenous emphysema
    • Bullectomy: May be considered in patients with space-occupying bulla (at least 1/3 of hemithorax)
    • Lung volume reduction surgery (LVRS): For patients with upper-lobe emphysema
    • Lung transplantation: May be considered in patients with severe COPD with FEV1 <50% and breathlessness refractory to medical therapy, non-smoker, completed pulmonary rehabilitation, where bullectomy, BLVR and LVRS are not applicable, and without any contraindications for transplantation
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