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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
C1. Aetiology and natural history
C2. Diagnosis
C2. 1 History
C2. 2 Physical examination
C2. 3 Spirometry
C2. 4 Flow volume tests
C3. Assessing the severity of COPD
C4. Assessing acute response to bronchodilators
C4. 1 Confirm or exclude asthma
C5: Specialist referral
C5. 1 Complex lung function tests
C5. 2 Exercise testing
C5. 3 Sleep studies  
C5. 4 Chest x-rays
C5. 5 High resolution computed tomography
C5. 6 Ventilation and perfusion scans
C5. 7 Transcutaneous oxygen saturation
C5. 8 Arterial blood gas measurement
C5. 9 Sputum examination
C5. 10 Haematology and biochemistry
C5. 11 Electrocardiography and echocardiography
C5. 12 Trials of Therapy
O: Optimise function
O1. Inhaled bronchodilators
01. 1 Short-acting bronchodilators
01. 1.1 Short-acting beta-agonists
01. 1.2 Short-acting anticholinergics
01. 1.3 Short-acting bronchodilator combinations
01. 2 Long-acting bronchodilators
01. 2.1 Long-acting beta-agonists
01. 2.2 Long-acting anticholinergics
01. 2.3 Long-acting bronchodilator combinations
01. 3 Assessment of response and continuation of bronchodilator therapy
02. Oral bronchodilators
02. 1 Methylxanthines
02. 2 Phosphodiesterase type-4 inhibitors
O3. Glucocorticoids
O3. 1 Oral glucocorticoids
O3. 2 Inhaled glucocorticoids
O4. Inhaled combination therapy
O4. 1 Inhaled glucocorticoids and long-acting beta-agonists in combination
O4. 2 Inhaled glucocorticoids and long-acting beta-agonists and long-acting anticholinergics in combination
O5: Inhaler technique
O6: Non-pharmacological interventions
O6. 1 Physical activity
O6. 2 Exercise training
O6. 3 Education and self-management
O6. 3.1 Psychosocial support
O6. 4 Pulmonary rehabilitation
O6. 5 Chest physiotherapy (Airway clearance techniques)
O6. 6 Nutrition
O7. Co-morbidities & drug safety
O7. 1 Aspiration
O7. 2 Gastro-oesophageal reflux
O7. 3 Alcohol and sedatives
O7. 4 Sleep related breathing disorders
O7. 5 Osteoporosis
O8. Hypoxaemia and pulmonary hypertension
O8. 1 Treatment
O9. Surgery
O9. 1 Bullectomy
O9. 2 Lung volume reduction surgery
O9. 3 Lung transplantation
O10. Palliation and end of life
O10. 1 Opioids
O10. 2 Advanced Care Plans
O10. 3 Palliative oxygen therapy for dyspnoea
P: Prevent deterioration
P1. Risk factor reduction
P1. 1 Smoking cessation
P1. 1.1 Nicotine replacement therapy
P1. 1.2 Bupropion
P1. 2 Prevent smoking relapse
P2. Influenza vaccination
P3. Pneumococcal vaccination
P4. Haemophilus influenzae vaccination
P5. Immuno-modulatory agents
P6. Antibiotics
P7. Anticholinergics
P8. Glucocorticoids
P9. Mucolytic agents
P10. Regular review
P11. Oxygen therapy
P11. 1 Fitness to fly
D: Develop support network and self-management plan
D1. Support team
D1. 1 General
D1. 2 Nurse/respiratory educator
D1. 3 Physiotherapist
D1. 4 Occupational therapist
D1. 5 Social worker
D1. 6 Clinical psychologist
D1. 7 Speech pathologist/therapist
D1. 8 Pharmacist
D1. 9 Dietitian
D1. 10 Non-medical care agencies
D2. Multidisciplinary care plans
D3. Self-management plans
D3. 1 Maintenance therapy
D3. 2 Exacerbations and crises
D4. Treat anxiety and depression
D5. Referral to a support group
D6. End-of-life issues
X: Manage eXacerbations
X1. Home management
X2. COPD acute exacerbation plan
X2. 1 Initial assessment of severity
X2. 2 Optimise treatment
X3. Refer appropriately to prevent further deterioration (‘P’)
X3. 1 Controlled oxygen delivery
X3. 2 Non-invasive positive pressure ventilation
X3. 3 Invasive ventilation (intubation)
X3. 4 Clearance of secretions
X3. 5 Monitor and review
X3. 6 Pulmonary rehabilitation
X3. 7 Discharge planning
X3. 8 Support after discharge
X3. 9 Clinical review and follow-up
Appendices
  Appendix 1
  Appendix 2
  Appendix 3
    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 - 286
  References reviewed but not cited

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