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Contents

Authors and contributors
Contents
Foreword
The COPD guidelines
Levels of evidence
Summary of the COPDX guidelines
C: Confirm diagnosis and assess severity
  Aetiology and natural history
  Diagnosis
    History
    Physical examination
    Spirometry
    Flow volume tests
  Assessing the severity of COPD
  Assessing acute response to bronchodilators
    Confirm or exclude asthma
  Specialist referral
    Complex lung function tests
    Exercise testing
    Sleep studies
    Chest x-rays
    High resolution computed tomography
    Ventilation and perfusion scans
    Transcutaneous oxygen saturation
    Arterial blood gas measurement
    Sputum examination
    Haematology and biochemistry
    Electrocardiography and echocardiography
O: Optimise function
  Symptom relief
    Inhaled bronchodilators
    Long-acting bronchodilators
    Theophyllines
  Assessment of response and continuation of bronchodilator therapy
    Short-course oral glucocorticoids
    Combination inhaled glucocorticoid/long-acting bronchodilator therapy
  Optimise inhaler technique
  Surgery
    Bullectomy
    Lung volume reduction surgery
    Lung transplantation
  Identify and treat aggravating factors
    Sleep apnoea, hypoventilation and hypoxaemia
    Gastro-oesophageal reflux
    Aspiration
    Alcohol and sedatives
  Hypoxaemia and pulmonary hypertension
  Osteoporosis
  Improve function
    Pulmonary rehabilitation
    Exercise training
    Patient education
    Psychosocial support
    Comprehensive integrated rehabilitation
    Chest physiotherapy
    Weight management and nutrition
P: Prevent deterioration
  Risk factor reduction
    Smoking cessation
  Influenza vaccination
  Pneumococcal vaccination
  Haemophilus influenzae vaccination
  Antibiotics
  Anticholinergics
  Glucocorticoids
  Mucolytic agents
  Regular review
  Oxygen therapy
    Fitness to fly
D: Develop support network and self-management plan
  Pulmonary rehabilitation
  Support team
    General practitioner
    Nurse/respiratory educator
    Physiotherapist
    Occupational therapist
    Social worker
    Clinical psychologist
    Speech pathologist/therapist
    Pharmacist
    Dietitian
    Non-medical care agencies
  Multidisciplinary care plans
  Self-management plans
    Maintenance therapy
    Exacerbations and crises
  Treat anxiety and depression
  Referral to a support group
  End-of-life issues
X: Manage eXacerbations
  Home management
  COPD acute exacerbation plan
    Initial assessment of severity
    Optimise treatment
  Refer appropriately
    Controlled oxygen delivery
    Non-invasive positive pressure ventilation
    Invasive ventilation (intubation)
    Clearance of secretions
    Monitor and review
    Pulmonary rehabilitation
    Discharge planning
    Support after discharge
    Clinical review and follow-up
Appendices
  Appendix 1
  Appendix 2
  Appendix 3
  Appendix 4
    Initiating oxygen therapy
    What the patient needs to know
    Review
    Dangers
    Choosing the right method
References
  References 1 - 50
  References 51 - 100
  References 101 - 150
  References 151 - 200
  References 201 - 251
  References 251 - 271
  References reviewed but not cited

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