4^thInternational Conference on Chronic Obstructive Pulmonary Disease May 29-31, 2017 Osaka,Japan

COPD symptoms are classified into Typical and non-typical type, which includes Chronic Cough, wheezing and shortness of breath and fatigue associated with sputum productions and the amount of sputum produced can change over hours to days. Typically the shortness of breath is worse on exertion of a prolonged duration and worsens over time. In the advanced stages, it occurs during rest and may be always present. It is a source of both anxiety and a poor quality of life in those with COPD. Many people with more advanced COPD breathe through pursed lips and this action can improve shortness of breath in some. Non Typical symptoms associated with Haemoptysis which can occur due to COPD, and also continuous expectoration of purulent sputum along with breathlessness without productive cough or wheezing. Clinical Features leads to high pressure on the lung arteries, which strains the right ventricle of the heart. This situation is referred to as corpulmonale, and leads to symptoms of leg swelling and bulging neck veins. Those with obstructed airflow may have wheezing or decreased sounds with air entry on examination of the chest with a stethoscope. A barrel chest is a characteristic sign of COPD.

COPD Management strategy consisting of combined pharmacotherapy and nonpharmacotherapeutic interventions can effectively improve symptoms, activity levels and quality of life at all levels of disease severity. Medical Management of COPD involves Oral and inhaled medications are used for patients with stable disease to reduce dyspnoea and improve exercise tolerance. Most of the medications used are directed at the four potentially reversible causes of airflow limitation in a disease state that has largely fixed obstruction. Beta2-agonist bronchodilators activate specific B2-adrenergic receptors on the surface of smooth muscle cells, which increases intracellular cyclic adenosine monophosphate (cAMP) and smooth muscle relaxation. Theophylline is a bronchodilator and an anti-inflammatory agent. Surgical Management of COPD including the surgical interventions directed only to patients who remain symptomatic despite optimal medical treatment. There are numerous surgical interventions for the treatment of the hyper expanded and poorly perfused emphysematous lung; these include costochondrectomy, phrenic crush, pneumoperitoneum, pleural abrasion, lung denervation, and thoracoplasty. Nursing Management of COPD involves maintaining adequate nutrition, the nurse explores the patient’s and family’s usual dietary habits and counsels the patient to select foods that provide a high-protein, high-calorie diet. The nurse encourages the patient to talk about anxiety and fears with family members and health care professionals. The nurse should foster a realistic assessment of abilities and limitations, with a focus on those activities the patient is still able to do. Positive body responses should be stressed without negating the seriousness of the health issues involved. Vocational rehabilitation may be an option for some patients. It is important to counsel the patient to select foods that derive their calories from high fat rather than high carbohydrate levels. Persons with advanced chronic bronchitis or emphysema are unable to exhale the excess carbon dioxide that is a natural end product of carbohydrate metabolism may elevate paco2 levels.

Chronic obstructive pulmonary disease (COPD) refers to a collection of lung diseases that can lead to blocked airways. People with COPD can be at risk for some serious complications that can not only put their health in jeopardy, but can also fatal. In COPD patients, Pneumonia occurs when bacteria enter the lungs, creating an infection. For COPD patients, pneumonia can weaken the lungs. This can lead to a chain reaction of illnesses that can weaken the lungs even further. This downward spiral can lead to a rapid deterioration of health in COPD patients. Respiratory Insufficiency is an important complication of chronic obstructive pulmonary disease. This may represent deterioration in the patient's premorbid condition such that hypoxemia worsens and hypercapnia develops during a relatively trivial respiratory tract infection, which may be viral or bacterial, Alternatively, these changes may occur for the first time in someone with less severe COPD who encounters a particularly dramatic cause for deterioration, e.g. lobar pneumonia or acute pulmonary oedema. Pneumothorax is defined as the accumulation of air or gas in the space between the lung and the chest wall. Also known as a collapsed lung, pneumothorax occurs when a hole develops in the lung that allows air to escape in the space around the lung, causing the lungs to partially or completely collapse. People with COPD, are at greater risk for pneumothorax because the structure of their lungs is weak and vulnerable to the spontaneous development of these types of holes. Pneumo mediastinum must be differentiated from spontaneous pneumothorax. Patients may or may not have symptoms, as this is typically a well-tolerated disease, although mortality in cases of esophageal rupture is very hig

Chronic obstructive pulmonary disease (COPD) is responsible for early mortality, high death rates and significant cost to health systems. Active smoking remains the main risk factor, but other factors are becoming better known, such as occupational factors, infections and the role of air pollution. Prevalence of COPD varies according to country, age and sex. This disease is also associated with significant comorbidities. COPD is a disorder that includes various phenotypes, the continuum of which remains under debate. Risk factors for developing COPD may be divided into two categories: exogenous (tobacco smoke, air pollution, work exposure, etc.) and endogenous (age, gender, genetic factors, etc.). Such factors, separately or in synergy, determine the subject’s susceptibility level for disease. Moreover, after adjusting for smoking, women exhibited a higher risk of being admitted to hospital for COPD than men. Tobacco smoking is the most important cause, but work exposure to noxious agents and air pollution play a remarkable role in the exacerbation and in the pathogenesis of chronic respiratory diseases, too. Thus, respiratory physicians, as well as public health professionals, should advocate for a cleaner environment.

No changes in physical appearance are usually present with mild-to-moderate COPD. In advanced COPD, patients with emphysema may be wasted and thin, with normal-colored pink skin, while those with chronic bronchitis may have bluish lips and fingers, be obese, and may have swollen feet and legs. Breathing may be rapid and shallow, done through pursed lips, with prolonged exhales. Common differential diagnosis of COPD includes clinical history; physical examination; and diagnostic testing, such as lung function measurements, can help diagnose COPD. Chest radiography may rule out alternative diagnoses and comorbid conditions. Patients with COPD often present with diminished with Physical Examination which includes breath sounds, prolonged expiratory time, and expiratory wheezing that initially may occur only on forced expiration. Additional findings on physical examination include hyperinflation of the lungs with an increased anteroposterior chest diameter (“barrel chest”). Patients with more advanced disease may have pursed lip breathing or postures that relieve dyspnea. The presence of significant edema may indicate right-sided heart failure and cor-pulmonale in patients with pulmonary hypertension from severe long-standing COPD. Chest x-rays are rarely useful for diagnosing chronic bronchitis, although they sometimes show mild scarring and thickened airway walls. Non-invasive Methods for Determining Severity, and also the short exercise tests are very useful for determining the severity of COPD.