Nihon rinsho. Japanese journal of clinical medicine
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COPD is a name proposed by two American doctors, M. H. Williams and N. ⋯ Since the 1970s, COPD has been considered a smokers' disease brought on chiefly by the chronic stimulation of tobacco smoke. In 2001, the GOLD guideline indicated that COPD should not refer to a disease combining chronic bronchitis and pulmonary emphysema, but rather to a disease state characterized by an airflow limitation that is not fully reversible. Nonetheless, problems still remain in defining this disease entity.
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According to the guideline presented by Global Initiative for Chronic Obstructive Lung Disease(GOLD), the diagnosis of chronic obstructive pulmonary disease (COPD) has been simplified. COPD is diagnosed when FEV1(forced expiratory volume in one second)/FVC(forced vital capacity) is less than 70% (except Stage 0), and also the severity of disease is classified by FEV1. In this article, spirometry, a screening test for COPD, is explained at first, and then further examination to understand the pathophysiology of COPD is discussed. For management and following-up of COPD, both lung function test and arterial blood gas analysis are important.
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COPD(Chronic Obstructive Pulmonary Disease) is a cause of chronic respiratory failure which leads to pulmonary hypertension and cor pulmonale. Not only chronic hypoxia but also low QOL(quality of life) due to dyspnea are shown to affect survival of COPD patients. ⋯ The induction of HOT needs a consideration of risk of narcosis and evaluations of oxygen desaturation during exercise and sleep as well as hypoxia at rest. Higher QOL of HOT patients might require an alteration of prescription guidelines of HOT.