Diagnosis and Management of Stable COPD: ATS, ACCP, ACP Practice Guideline (Review, Ann Intern Med) - PulmCCM
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Dec 262011
 

The ACP, ACCP, ATS and ERS give us this new clinical practice guideline & review on managing stable COPD. To sum up their recommendations:

1. If symptomatic, those with suspected COPD should be diagnosed with spirometry and offered treatment with bronchodilators if they indeed have COPD.

2. If FEV1 < 60% – then definitely treat with a single long-acting bronchodilator (LABA or anticholinergic).

3. And an inhaled steroid if you want to (this conflicts with GOLD’s guideline that frequent exacerbations also be present).

4. Pulmonary rehabilitation if FEV1 < 50%; or earlier if you like.

5. Oxygen for the severely hypoxemic (paO2 < 55 mmHg or SaO2<=88%)

Oh, and smoking cessation counseling for everyone who smokes.

Were you expecting more?

Qaseem et al. Ann Intern Med 2011;155:179-191.

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  One Response to “Diagnosis and Management of Stable COPD: ATS, ACCP, ACP Practice Guideline (Review, Ann Intern Med)”

  1. I think the treatment shall depend upon the patient, e.g treating a patient for the first time will differ from one already known to me. As for relying on the PFT, I think this will be very difficult during an exacerbation. I suppose that when we can one day manage to measure the functions of the lung of the patient without involving the patient directly, will we be able then to categorize our patients. Personally I find great difficulty in making my patients perform the tests acc to the guidelines.

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