COPD

What is COPD?
COPD is a general term used to describe the progressive and permanent lung damage caused by two respiratory diseases; chronic bronchitis and emphysema. These diseases may occur together, or by themselves, and usually occur after age 50.

COPD CAUSES:
cigarette smoking
pollutants inhaled from the environment
genetic factors

Emphysema occurs when the lung's tiny air sacs, or alveoli, become over-inflated and damaged. The walls between the alveoli break down, creating large spaces that do not move air efficiently. The lungs lose elasticity, and cannot inflate and deflate well. Air becomes trapped, and exhalation becomes difficult. As a result of the lungs staying partially inflated, a "barrel chest", or enlargement of the rib cage, often occurs.

The main sign of emphysema is shortness of breath, especially with any exertion or activity. Other signs include fatigue, weight loss, and weakness. When oxygen levels fall in the body, shortness of breath occurs in an attempt to bring in needed oxygen rapidly. Weakness and fatigue develop when the body's cells cannot function properly due to inadequate oxygen. Weight loss occurs because poor oxygenation makes the process of eating too tiring, and the increased work of breathing uses extra calories.

Chronic bronchitis results from long-term inflammation of the bronchi, the main tubes that bring air into the two lungs. This chronic inflammation results in excess mucous production, which can block the airways and interfere with air exchange. Also, the bronchial walls become thickened, causing these important airways to become narrowed. Eventually, the alveoli may also suffer irreversible damage.

Signs of chronic bronchitis include a productive cough that lasts for several months, especially during cold weather. Repeated respiratory infections often occur, becoming more frequent as the disease progresses. Mucous production increases over time, and fatigue and weakness affect lifestyle.

There is no cure for COPD, since these conditions are irreversible and progressive. Treatment is aimed at relief of symptoms. The first step is to eliminate exposure to irritants, such as cigarette smoking. Medications called bronchodilators and are administered to help open the airways and promote air exchange. These are often administered by inhaler or nebulizer, but may also be taken as a pill. Sometimes, steroids are taken to decrease inflammation of the respiratory tract. Supplemental oxygen may be needed, usually administered via a nasal cannula. Oxygen may be stored in a tank that requires refilling or an oxygen concentrator, which is a machine that produces oxygen from room air.

How to Improve Oxygenation in a patient of COPD
Patients with COPD are usually more comfortable with the head elevated. Many prefer to lean forward as they sit, in an attempt to increase air exchange. Avoid laying them flat if this causes shortness of breath. If oxygen is in use, make sure that it stays at the prescribed amount. Low amounts of oxygen, usually 1-2 liters per minute, are given, since high levels may cause these patients to lose their drive to breathe. Always observe oxygen safety precautions, ensuring that no one smokes or has open flames nearby. Frequent mouth care is needed, every 2 hours, since oxygen therapy can be very drying. Watch carefully for signs that they are not getting enough oxygen, especially when moving around or exerting themselves. These signs may include increased respiratory rate(over 24/min), increased pulse rate (over 100/min.), labored breathing, and pale or bluish skin color. Also watch for respiratory infection, such as increased congestion and mucous production, fever, or chest pain.