Пулмология

At-A-Glance Outpatient
Management Reference
for Chronic Obstructive
Pulmonary Disease (COPD)
At-A-Glance Outpatient
Management Reference
for Chronic Obstructive
Pulmonary Disease (COPD)
BASED ON THE GLOBAL STRATEGY FOR DIAGNOSIS,
MANAGEMENT AND PREVENTION OF COPD
GLOBAL INITIATIVE FOR CHRONIC OBSTRUCTIVE LUNG DISEASE (GOLD)
UPDATED 2016
Please refer to the GOLD Report (updated 2016) at www.goldcopd.orgCOPYRIGHTED MATERIAL- DO NOT ALTER OR REPRODUCE

DIAGNOSING COPD
A diagnosis of COPD should be considered in any individual who has
dyspnea, chronic cough or sputum production, and a history of exposure
to risk factors for the disease, especially cigarette smoking.
Consider COPD, and perform spirometry, if any of these indicators
are present in an individual over age 40. These indicators are not
diagnostic themselves, but the presence of multiple key indicators
increases the probability of a diagnosis of COPD. Spirometry is
required to establish a diagnosis of COPD.
Dyspnea
that is: Progressive (worsens over time).
Characteristically worse with exercise.
Persistent.

Chronic cough: May be intermittent and may be unproductive.
Chronic sputum production:
Any pattern of chronic sputum production may
indicate COPD.
History of exposure to risk factors:
Tobacco smoke (including popular local preparations).
Smoke from home cooking and heating fuels.
Occupational dusts and chemicals.
Family history of COPD
Table 1. Key Indicators for Considering a Diagnosis of COPD
Spirometry is required to make a clinical diagnosis of COPD; the presence of
a postbronchodilator FEV
1
/FVC < 0.70 confirms the presence of persistent
airflow limitation and thus of COPD. All health care workers who care for
COPD patients should have access to spirometry.COPYRIGHTED MATERIAL- DO NOT ALTER OR REPRODUCE

ASSESSMENT OF COPD
The goals of COPD assessment are to determine the severity of the disease, its