Advanced Chronic Obstructive Pulmonary Disease

Advanced Chronic Obstructive Pulmonary Disease

Definition

Advanced COPD is the later stages of COPD. Airflow gets worse, even with treatment. This leads to severe tiredness and problems doing basic tasks.

Causes

Advanced COPD is due to more lung damage over time. Damaged tissue makes it harder for oxygen to move into the blood. It also takes extra work to push air out of the lungs. This is often part of normal COPD as it gets worse.

Risk Factors

COPD gets worse over time. Things that speed up lung damage are:

  • Problems with the treatment plan
  • Smoking
  • Secondhand smoke
  • Related medical problems such as heart disease

Symptoms

Advanced COPD can cause:

  • More problems breathing, even at rest
  • A feeling of choking when lying flat
  • Tiredness
  • Problems staying focused
  • Weight loss
  • Breathing through puckered lips
  • Urge to lean forward to help breathing

Diagnosis

The doctor will ask about symptoms and history of COPD. Breathing tests will be done. This may be enough to diagnose advanced COPD.

The doctor may do blood tests and chest x-rays. This can help find infections or other conditions that can make breathing worse. If there is an infection, symptoms may get better once it has passed

Treatment

The goal is to treat COPD and help ease symptoms. Medicine and oxygen therapy will still be used. However, doses or use may be changed.

Other options to help breathing are:

  • Avoiding extreme heat and cold
  • Not smoking
  • Staying away from secondhand smoke and chemicals
  • Staying indoors if air quality is poor
  • Using fans

Occupational therapy and devices may help make tasks easier. This can ease demand on the lungs. It can also help reduce tiredness.

Other options may be:

  • Diet changes to treat unwanted weight loss
  • Surgery or procedures, if advised, such as:
    • Lung volume reduction surgery—removing a section of lung to let other parts expand
    • Bronchoscopic lung reduction—a procedure to block off parts of the lung
    • A lung transplant—replaces damaged lungs with donor lungs
  • Palliative care—treatment to improve comfort
  • Advanced directives—legal planning for future care decisions
  • Hospice at home or in a care center—comfort care for end of life COPD

Prevention

Advanced COPD cannot always be prevented. Following a care plan and healthy habits can help delay it.

RESOURCES:

American Lung Association
http://www.lung.org
Centers for Disease Control and Prevention
http://www.cdc.gov

CANADIAN RESOURCES:

College of Family Physicians of Canada
https://www.cfpc.ca

References:

COPD. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/copd. Accessed August 11, 2021.
COPD. National Heart, Lung, and Blood Institute website. Available at: https://www.nhlbi.nih.gov/health-topics/copd. Accessed August 11, 2021.
O'Donnell DE, Milne KM, et al. Dyspnea in COPD: new mechanistic insights and management implications. Adv Ther. 2020 Jan;37(1):41-60.
Palliative and hospice Care. National Institue on Aging website. Available at: https://www.nia.nih.gov/health/what-are-palliative-care-and-hospice-care. Accessed August 11, 2021.
Last reviewed July 2021 by EBSCO Medical Review Board Dan Ostrovsky, MD
Last Updated: 8/11/2021

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