Management of severe COPD

Lancet. 2004 Sep 4-10;364(9437):883-95. doi: 10.1016/S0140-6736(04)16984-5.


Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality worldwide, and the burden of the disorder will continue to increase over the next 20 years despite medical intervention. Apart from smoking cessation, no approach or agent affects the rate of decline in lung function and progression of the disease. Especially in the later phase, COPD is a multicomponent disorder, and various integrated intervention strategies are needed as part of the optimum management programme. This seminar describes largely non-pharmacological interventions aimed at improving health status and function of disabled patients. Exacerbations become progressively more troublesome as baseline lung function declines, commonly necessitating hospital admission and associated with the development of acute respiratory failure.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Acute Disease
  • Adrenergic beta-Agonists / therapeutic use
  • Edema / etiology
  • Edema / physiopathology
  • Humans
  • Lung Transplantation
  • Pneumonectomy
  • Prognosis
  • Pulmonary Disease, Chronic Obstructive / complications
  • Pulmonary Disease, Chronic Obstructive / physiopathology
  • Pulmonary Disease, Chronic Obstructive / therapy*
  • Respiration, Artificial / methods
  • Respiratory Insufficiency / etiology
  • Respiratory Insufficiency / therapy
  • Water-Electrolyte Imbalance / etiology
  • Water-Electrolyte Imbalance / physiopathology
  • Weight Loss


  • Adrenergic beta-Agonists