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Editorials |6 September 2005

Therapeutic Gains of Prolonged Bronchial Dilatation in Chronic Obstructive Pulmonary Disease

Gerard M. Turino, MD

Article, Author, and Disclosure Information
Author, Article, and Disclosure Information
  • From St. Luke's-Roosevelt Hospital, Columbia University College of Physicians & Surgeons, New York, NY.

    Potential Financial Conflicts of Interest: Grants received (Boehringer Ingelheim); Grants pending (Boehringer Ingelheim).

    Requests for Single Reprints: Gerard M. Turino, MD, St. Luke's-Roosevelt Hospital, 1000 10th Avenue, New York, NY 10019.

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Chronic obstructive pulmonary disease (COPD) is a major global medical problem. In the United States, COPD causes more than 500 000 hospitalizations and 100 000 deaths per year (1, 2). As many as 25 million individuals are estimated to have various stages of COPD in the United States (3). The definition of COPD, which resulted from a National Heart, Lung, and Blood Institute and World Health Organization conference, is “a disease state characterized by airflow obstruction that is not fully reversible. The airflow obstruction is usually both progressive and associated with an abnormal inflammatory response of the lung to noxious particles or gases” (4).
The clinical spectrum of COPD includes chronic bronchitis, emphysema, and refractory asthma. In most patients with advanced disease, each of these disorders may be present but in variable proportions. There is also an awareness of the need to include variables such as body mass index, dyspnea, and exercise capacity in categorizing patients with COPD, along with spirometric measurements (5). However, as indicated, the major manifestation of COPD, regardless of the variable diagnostic components, is airway obstruction. Another important feature, and a significant factor in the clinical course of patients with COPD, is the occurrence of clinical exacerbations (6). Exacerbations that occur with a usual frequency of 1 to 3 events per patient per year result in a more rapid decrease in lung function but also substantially affect quality of life and the economic cost of COPD (7, 8).
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Turino GM. Therapeutic Gains of Prolonged Bronchial Dilatation in Chronic Obstructive Pulmonary Disease. Ann Intern Med. 2005;143:386–387. doi: 10.7326/0003-4819-143-5-200509060-00014

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Published: Ann Intern Med. 2005;143(5):386-387.

DOI: 10.7326/0003-4819-143-5-200509060-00014

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2005 American College of Physicians
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