Chronic Obstructive Pulmonary Disease
Chronic Obstructive Pulmonary Disease (COPD) is defined as the situation in which there is permanent obstruction of the airways following a chronic history of shortness of breath, increased sputum and wheeze. It results from a spectrum of conditions including chronic bronchitis and emphysema, and by far the commonest cause in the UK is cigarette smoking. It is thought that it may be a consequence of repeated episodes of infection in conjunction with an underlying asthmatic tendency. At one end of this spectrum of disease are patients who are pink and short of breath - so-called "pink puffers" while at the other end there are patients who retain carbon dioxide - the "blue bloaters" who develop heart failure and polycythaemia (see the heart and circulation). Besides vaccination against flu and pneumococcal infection, patients with COPD need to be treated vigorously for any infection which may worsen their condition. In severe cases there may be a risk of respiratory failure, and they may benefit from having an oxygen supply at home (though not, of course, if they are smokers!)
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